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

2. Ortho Jeopardy

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

4. YES/NO?

9. YES/NO? Was it Right?

10. Case Example 2.5 monthsRevision

11. YES/NO?

16. What is the Future?

17. 2.5 weeks

18. Symptomatic Hardware

19. Happier!

20. YES/NO?

21. Critique?

22. 2 weeks

23. Revision at 3 weeks

24. YES/NO?

25. Critique?

26. First Post Op: WHY?

27. Follow Up

28. When Is K-wire and Tension Banding Too much?

29. 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

30. 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

31. 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”

32. 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