J Korean Orthop Assoc.  1975 Dec;10(4):410-417. 10.4055/jkoa.1975.10.4.410.

Tension Wiring in the Treatment of the Olecranon, Patella and Malleolar Fracture

• Goo JH
• Ahn JH
• You MC

• KMID: 2471405
• DOI: http://doi.org/10.4055/jkoa.1975.10.4.410

Abstract

We have experienced twenty two fractures involving joint, eight olecranon, seven patella, and other seven malleolus respectively. All these fractures were treated by open reduction and tension band wiring. The advantages obtained in tension band wiring are as follows; 1. Good apposition and firm internal fixation can be achieved. 2. Tension band is of benefit to fracture healing by firm fixation in cancellous part. 3. Early joint motion and weight bearing reduce the degree of disability and speed up functional restoration. 4. Further remedial treatment such as physical therapy after prolonged plaster immobilization is usually unnecessary. 5. Tension band wiring is recommended the treatment of choice beyond all other methods of internal fixation in above fractures involving intra-articular surface.

MeSH Terms

Fracture Healing
Immobilization
Joints
Olecranon Process*
Patella*
Weight-Bearing

Figure

• 

  刈䙄 1. 2個㢨 Kirschner wire ⹠ 尺敘㨰 㽃㡻 ⤼ K-wire tightner 䞤 fc8;ô字 wire䚄 㞐㢈䴜.

• 

  刈䙄 2. 2個㢨 Kirschner wire 䚄 㢌㥗⪨㨔 “8”字形 Tension Band Wire 䞤 匘㟸䊀䚄 協匠⪨却 㣠㙀⪨匠 㡸䴜.

• 

  刈䙄 3. 纁敘內煿敘折㨰 使用⪤ Tension Band Wiring ㇟䖌, 㟼䖌䰼

• 

  刈䙄 4. 㵔古匘匘㟸㨰 㽃㡻䯤 Tension Band Wiring

• 

  刈䙄 5 㜄䮰匘㟸 例 3㨰㻤 㷨㵔 4㜄⤼ 㜄匀㟸㢨 㥌 䬏㢌 完全⡸ ⥴䌋䯤 㼿⼤䚄 䇴㢌匠 㡸䴜.

• 

  刈䙄 6. 牍樤㘙煿敘拆例 3㨰㻤 㷨㷠 5㜄㨰㻤 㞏匀㟸 㥌䬏䠷㢌 㦼㟼⡸ ⥴䌋䯨匠ô䰧⹋㨺㢌 ⦨㇟ ⪨㙀䞤 ㍌㛯䊀⪨䚄 ⪠ 㷨 㡸㢴㢼 䌌㨔㜄匠 㡸䴜(㽃㡻䰼).

• 

  刈䙄 7. 20㻈 佘㡰(例 3) 劰⹋㽔匠䞤 㜄䮰匘㟸㢼 䏥㪨㢴. a) 㷨㼿㘿⤼ X-㻠 b) Tension Band 䏱 K-Wire 匠㟫⪤ 㷨㷠㘿⤼ 㽔㘼, 匘㟸㻠㢼 厐㢨 ㏂㪼䌌凐 ⡨䬜䴜 c) 㷨㷠 4㜄 ⤼ 㽔㘼. 㴠㼣吀匘䬏 匘㣠⪗㨰 䌄 㷨 㡸䵬 匘䘷䏨㢯㣀 䌄 㷨 㨺䴜. d) 㷨㷠 6古㤬 ⤼ Tension Band 㟤厐 ⤼ 㽔㘼, 匘㟸䊀 ⧄㟿㣀 ㏂㪼䌌凐 ⡨䬜䴜.

• 

  刈䙄 8. 39㻈 佘㡰(例 4) a) ㉬䢃㽔匠䞤 㵔古匘 匘㟸㢼 䌌㨔㜄匠 㡸䴜. b), c) Tension Band 匠㟫㘿⤼ 㽔㘼, 匘㟸㻠㢼 ㏂凐 ⡨䬜䴜. d) 㷨㷠 3古㤬 ⤼ 㽔㘼ô㷨㷠㘿⤼ 㽔㘼匄 䆼劰⪨㨔 Trateculation 㢨 㨐卐 㢌㦈 䴜䚈 䍀⦬䚄 ㏂㪼 䌄 㷨 㨺䴜.

• 

  刈䙄 9. 39㻈 佘㡰(例 5) a) 㩯㇟煿匘㟸㢼 䌌㨔㜄匠 㡸䴜. b) 㩯㇟㨰 䕘䮰 tension band 匠㟫 㘿⤼ 㽔㘼. 匘㟸㻠㢼 㟼⨀ ㏂凐 ⡨䬜䴜. c) 㷨㷠 8㜄⤼ 㽔㘼, 匘㟸㻠㣀 䌄 㷨 㨺匠ôtrabeculation 㢨 㨐卐㢼 䌄 㷨 㡸䴜. d) wire 㟤厐 ⤼ 㽔㘼ô匘㟸㢨 ⧄㟿㢼 ㏂㢼 㷨 㨺䴜.

Reference

1.Adler S.., Fay G. W.., MacAusland W. R. Jr.Treatment of olecranon fractures, Indica lions for excision of the olecranon fragment and repair of the triceps tendon. J. J. trauma. 2:597. 1962.

2.Aldredge G. N. Jr.., Gregory C. F.Triceps advancement in olecranon fractures, J. B. J. S., 51 A:. 1969.

3.Anderson I. D.Compression plate fixation and different types of internal fixation on fracture healing. J.Ë.J.S. 47 A:191. 1965.

4.Anderson L. D.., Sisk T. D., et al. Compression plate fixation in acute diaphyseal fractures of the radius and ulna. J.B.J.S. 57A:287–296. 1975.

5.Eagby G. W.., Janes J. M.The effect of compression on the rate of fracture heeling using a surgical plate, Ameri. J.S. 95:714. 1958.

6.Bostöm A. Fractures of the patella: Acta. Orthop. Scand. 143(suppl.):1–80. 1972.

7.Brooke R.Fractured, patella analysis of 54cases treated by excision. British Med. J. 1:231–233. 1946.

8.Burwell H. N.., Charnley A. D.The treatment of displaced fractures at the ankle by rigid internal fixation and early joint rnovement. J. J.B.J.S. 47B:634–660. 1965.

9.Bush L. F.., McClain E. J. Jr.Operative treatment of fractures of the elbow in adults. American Academy of Orthopedic Surgeons Instructional Course lecturesr. 16:265. The C. V. Mo shy Co. St. Louis.1959.

10.Charnley J.., Baker S. L.Compression arthrodesis of the knee a clinical and historical study,. J. B. J. S. 34:1875. 1952.

11.Colton C. L.The treatment of Dupuytrenss fracture dislocation of the ankle,. J.B. J.S. 53B:69. 1971.

12.Crenschaw A. H.Campbell's operative orthopedics,. 5th ed.The C. V. Mosby Co. St. Louis;1971.

13.DePalma A. F.The ‘management of fractures and Dislocations. Philadelphia, W. C. Saunders. 1959.

14.Eggers G. W. N.., Shindler T. O.., Pomerat C. M.The influence of the contact compression fracturs on osteogenesis in surgical fractures. J.B.J.S., 3lA: 693. 1949.

15.Ford L. T.., Key J. A.The experimental study of the effect of pressures on healing of bone. Arch. Surg. 69:627. 1954.

16.Friedenberg Z. B.., French G.The effects of known compression forces on healing of bone. Surg. Cyn. and Obst. 94:143. 1952.

17.Haxton H.The function of the patella and effects of its excision, Surg. Gyne and Obst. 80:395. 1945.

18.Käufer H.Mechanical function of the patella. J.B.J.S. 53A:1551–1560. 1971.

19.Keon-Cohen B. T.Fractures at the elbow,. J.B.J.S. 48A:1623. 1966.

20.Key J. A.Positive pressure in orthrodesis for Tuberculosis of the knee joint. South. M. J. 25:909–914. 1932.

21.Knight R.A.The management of fractures about the elbow in adults. American Academy of Orthopedic Surgeons Instructional Course lectures 14. Ann Arbor. 1957. J. W. Edwards.

22.Laurin C. A.., Sisón V.., Rogue N. Mechanical investigation of experimental fractures Canadian. J. S. 6:218–228. 1963.

23.Mckeever D. C.Patellar prosthesis. J. B. J. S. 39 A:1074–1884. 1955.

24.Mckeever F. M.., Buck R. Μ.Fracture of the olecranon process of the ulna. J.A.M.A. 135:1. 1947.

25.Müller M. E.Internal fixation for fresh fracture and for nonunion, proc. Rcy. Soc. Med. 56:455. 1963.

26.Müller M. E.., Allgöwer M.., Willenger H.Manual of internal fixation, Berlin, Heidelberg, New York, Springer-Verleg. 1970.

27.Olerud S.., Danckwardt-Lillistrom G.Fracture healing in compression osteosynthesis. Acta. Orthop. Scand. (Suppl.). 137:1971.

28.Perren S. M.., Allgöwer M.., Ehrsam R.., Zanz N.., Matter P.Clinical experience with a new compression plate “DCP” A.cta. Orthop. Scand (suppl.). 125:1969.

29.Perren S. M., et al. Cortical Bone healing: The Reaction of cortical bone to compression. Acta. Orihcp. Scand. (Suppl.). 125:19–28. 1969.

30.Pollock W. J.., Parkes J. H.Early reconstruction of the elbow following severe trauma, f. Trauma. 10:839. 1970.

31.Quigley T. B., et al. Advances in the management of fractures and dislocation in past decade. Orthop, clinic of north Ameri. 3:No.(3):803. Nov. 1972.

32.Rahn B. A., et al. Primary bone healing. J.B. J.S. 53A:786. 1971.

33.Rockwood C. A.., Green D. P.Fractures. J. B. Lippincott. 1975.

34.Schatzker J.Fixation of olecranon fractures in the dogs with tension bands, f. B. J. S. 53B:158. 1971.

35.Smillie I. S.Injuries of the knee joint, ed. 4. Edinburgh, E&S, Livinstone. 1970.

36.Stewart M. J.., Bland W. G. Compression in arthrdesis. A comperative study of methods of fusion of the knee in ninety-three cases. J. J.B.J.S. 40A:585. 1958.

37.Thompson J. E. M.Fracture of the patella treatment by removal of the loose fragments and plastic repair of the tendon. A study of 554 cases. Surg. Gynecol. &. Obst. 74:860–866. 1942.

38.Taylor T. K.F.., Scham S. M.A Posteromedial approach to the proximal end of the ulna for the internal fixation of olecranon fractures, f. Trauma. 9:594. 1969.

39.Warner W. C.., Farber L. A.Trimalleolar fractures. Sourthern Med. J. 58:1292. 1965.

40.Wilson F. C.., Skilbred L. A.Long term results in the treatments of displaced bimalleolar fractures,. J.B.J.S. 48A:1065–1078. 1966.

41.Young C.Primary elbow arthroplasty. Arch. Surg. 101:78. 1970.