Transcript Orthopaedic Basics for EMS

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?
YES/NO?
YES/NO?
Was it Right?
Case Example
2.5 months
Revision
YES/NO?
YES/NO?
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


Comminution of joint surface
 Simple
Tension band
wire
 Comminuted
Plate fixation
Orientation of fracture line
 Transverse
Tension band
wire
 Oblique
Plate fixation
Purpose of the Tension
Band




Fractures require mechanical stability to
heal
Fractures respond well to compression
 Evaluate dorsal cortex
Fractures react adversely to repeated
tension/distraction
Tension band converts tensile forces of
triceps into compressive forces
Technique




Reduce Fracture
Drill hole for wire
with a 2.0 mm drill
dorsal
Tension with elbow
extended
Tension Band Wire
 figure of “8”
Tension Band Fixation Tips


Place wires parallel
to each other and
perpendicular to fx
Insert in a proximal
dorsal to distal
anterior


Remember you
have to advance
wires so leave
room!
Tip: Check ROM
prior to closing