Ali Mohammed, Kuiper Jan, John Joby
Trauma and Orthopaedics, North Cumbria NHS Trust, UK.
Chin J Traumatol. 2016 Oct 1;19(5):255-258. doi: 10.1016/j.cjtee.2016.06.009.
Tension band wiring is commonly used for fixation of simple transverse fractures. The popular configuration is parallel Kirschner wires (K-wires) and a stainless steel wire loop placed in a vertically oriented figure-of-8.
We used a wooden model of a patella with a midway transverse fracture and compared four different types of fixation. The first construct had a vertical figure-of-8 with one twist of wire. The second contained a vertical figure-of-8 with two twists of wire. The third was a vertical figure-of-8 with two twists of wire placed at adjacent corners while the last one had a horizontal figure-of-8 with two twists of wire placed at adjacent corners. Interfragmentary compression at the point of wire breakage was measured for each construct as well as permanent displacement on cyclic loading.
Placement of the figure-of-eight in a horizontal orientation with two wire twists at the corner improved interfragmentary compression by 63% (p < 0.05, Tukey post hoc test). On cyclic loading, all the constructs with vertical figure-of-eight but none with a horizontal construct failed (p=0.01; Fisher's exact test). Permanent fracture displacement after cyclic loading was 67% lower with horizontal figure- of-eight constructs (p < 0.05; t test).
Placing wire twists at the corner and a horizontal placement of figure-of-8 improves stability of the construct.
张力带钢丝常用于简单横行骨折的固定。常用的构型是平行克氏针（K 针）和置于垂直8字构型的不锈钢丝环。
我们使用了一个带有横行中段骨折的髌骨木制模型，比较了四种不同类型的固定方式。第一种结构是带有一圈钢丝扭转的垂直8字构型。第二种包含带有两圈钢丝扭转的垂直8字构型。第三种是带有两圈钢丝扭转且钢丝扭转位于相邻角部的垂直8字构型，而最后一种是带有两圈钢丝扭转且钢丝扭转位于相邻角部的水平8字构型。测量每种结构在钢丝断裂点的骨折块间压缩力以及循环加载时的永久位移。
在角部有两圈钢丝扭转的水平8字构型使骨折块间压缩力提高了63%（p < 0.05，Tukey 事后检验）。在循环加载时，所有垂直8字构型的结构均失败，而水平构型的结构无一失败（p = 0.01；Fisher 精确检验）。循环加载后，水平8字构型结构的骨折永久位移降低了67%（p < 0.05；t检验）。
在角部进行钢丝扭转以及8字构型的水平放置可提高结构的稳定性。
