Rigid internal fixation of intra-articular fractures by tension band wiring - abstract

ABSTRACT

Based on the principle that "The implant absorbs the tension and bone the compression" of the A. O. group, a number of suitable fractures have been treated by Tension Band Wiring. Using this technique, we have treated 19 fractures of the olecranon, 14 of the patella and 23 of the medial malleolus, at the University Hospital of the West Indies and at Hoberton Hospital, St. John's, Antigua. In spite of intensive physiotherapy, starting the day following surgery, 905 of the patients with fractures of the olecranon and medial malleolus showed evidence of clinical and radiological union at the end of six weeks, with almost full range movements at elbow and ankle joints. The average period of clinical and radiological union in fractures of the patella was 76 days; 95 percent of the patients in the patella series progressed to full weight bearing at the end of 12 weeks with a full range of motion at the knee. Complications which developed (average follow-up of 7.4 months) were 7 percent superficial infections and in 16 percent pain continued at the fracture site until the implant was removed. It has been found that if the patient, implant fracture and technique were properly matched, the results of this short surgical procedure were excellent. Painless stability is afforded so that early active joint movement can be obtained throughout the phase of bone healing. The patient goes back to work earlier, with less complications, compared with other methods of treatment (AU)