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  1. Elizabeth Thompson
  2. Amir K. Robe
  3. Simon C. Roe

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Description: Tension band wiring is a common fracture stabilization technique for counteracting distraction forces on a bone fragment. Previous studies optimizing performance of the tension band technique have focused on testing the overall construct, which includes the tension band configuration and K-wires or pins inserted across the fracture line. Using a metal trochanteric osteotomy model based on a canine femur, this study investigated the stability of the wire portion alone without confounding contributions of K-wire stabilization and bone stiffness. Four standard tension band configurations were applied to this model: figure-of-eight with one twist (OT) or two twists (TT), dual interlocking single loop (DISL), and double loop (DL). Configurations were mechanically tested under both monotonic and incremental cyclic loading. Initial resting tension after tying, tension remaining after each cycle, and load at 2 mm of displacement (clinical failure) were measured. The DL was the strongest and most stable configuration, generating greater resting tension, maintaining a greater percentage of resting tension under cyclic load, and resisting higher load before failure at 2 mm. Failure load was highly correlated with initial resting tension. Wire configurations that can be tightened effectively during tying, like the DL, are better able to resist the tensile load on the construct. This model for evaluating tension band wire performance could be useful to inform surgical decision-making about configuration type and tying method to achieve optimal fracture stabilization.

License: CC-By Attribution 4.0 International


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