From the Guidelines
The primary purpose of a tension band wire, such as a Kirschner wire, in orthopedic surgery is to convert tensile forces into compressive forces, thereby promoting bone healing in areas where muscle forces tend to distract bone fragments. This technique is particularly useful in fractures with strong deforming muscle forces, as it neutralizes these forces and promotes primary bone healing 1.
Key Applications
- The method involves placing wires in a figure-of-eight pattern across the fracture site, which is commonly used for fractures of the patella, olecranon, medial malleolus, and greater tuberosity of the humerus.
- The procedure typically involves using Kirschner wires (K-wires) for initial stabilization, followed by stainless steel wire looped in the tension band configuration.
Mechanism and Benefits
- This creates compression at the fracture site during joint movement and muscle contraction, which is essential for promoting bone healing.
- The technique is particularly effective for fractures with strong deforming muscle forces, as it neutralizes these forces and promotes primary bone healing, ultimately reducing long-term morbidity and chronic pain 1.
Considerations and Complications
- Potential complications include wire migration, soft tissue irritation, and the need for hardware removal after healing.
- Postoperative management usually involves early protected range of motion exercises to maintain the compression effect while allowing the fracture to heal properly.
From the Research
Purpose of Tension Band Wire
The purpose of a tension band wire, also known as a Kirschner wire, in orthopedic surgery is to provide fixation and stability to fractures, particularly in areas such as the patella and olecranon.
- The tension band wire technique is used to treat fractures by converting distracting forces into compressive forces, thereby promoting healing and stability [(2,3,4,5,6)].
- This technique involves the use of Kirschner wires and a wire loop to provide fixation and compression to the fracture site [(2,4,5)].
Biomechanical Comparison
Studies have compared the biomechanical properties of different fixation techniques, including the use of metal wire and high-strength suture tension bands 6.
- The results of these studies have shown that high-strength suture tension bands can provide equivalent fixation strength to metal wire tension bands 6.
- The use of Kirschner wires and a wire loop has been shown to provide stable fixation and promote healing in fractures of the patella and olecranon [(2,3,4,5)].
Clinical Applications
The tension band wire technique has been used to treat a variety of fractures, including patella and olecranon fractures [(2,3,4,5)].
- The technique has been modified and refined over time to improve outcomes and reduce complications [(2,3,4,5)].
- Studies have shown that the use of tension band wiring can provide excellent functional results and promote healing in fractures of the patella and olecranon [(2,3,4,5)].