Tension Band Wire Acknowledgements: Lisa K. Cannada, MD.

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Presentation transcript:

Tension Band Wire Acknowledgements: Lisa K. Cannada, MD

Ortho Jeopardy

The Answer: What is TBW? Please decide if the answer is correct for the following fractures

YES/NO?

YES/NO? Was it Right?

Case Example 2.5 monthsRevision

YES/NO?

What is the Future?

2.5 weeks

Symptomatic Hardware

Happier!

YES/NO?

Critique?

2 weeks

Revision at 3 weeks

YES/NO?

Critique?

First Post Op: WHY?

Follow Up

When Is K-wire and Tension Banding Too much?

Surgical Decisions l Comminution of joint surface Ý SimpleTension band wire Ý ComminutedPlate fixation l Orientation of fracture line Ý TransverseTension band wire Ý ObliquePlate fixation

Purpose of the Tension Band l Fractures require mechanical stability to heal l Fractures respond well to compression Ý Evaluate dorsal cortex l Fractures react adversely to repeated tension/distraction l Tension band converts tensile forces of triceps into compressive forces

Technique l Reduce Fracture l Drill hole for wire with a 2.0 mm drill dorsal l Tension with elbow extended l Tension Band Wire Ý figure of “8”

Tension Band Fixation Tips l Place wires parallel to each other and perpendicular to fx l Insert in a proximal dorsal to distal anterior Ý Remember you have to advance wires so leave room! l Tip: Check ROM prior to closing