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
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