Subscribe to RSS
DOI: 10.1055/s-0038-1633003
The effects of wire diameter and an additional lateral wire on pin and tension-band fixation subjected to cyclic loads
Publication History
Received
09 January 2006
Accepted
09 April 2006
Publication Date:
22 February 2018 (online)

Summary
Despite reports of frequent complications, pin and tension-band wire remains the most common repair of simple olecranon fractures and osteotomies (1–5). A recent mechanical study found wire diameter to be the key determinant of pin and tension-band construct strength; models with 1.25-mm wire were much stronger than those with standard 1.0-mm wire exposed to single loads to failure (6). Additionally, fixation strength was also increased when a lateral wire was used in combination with a standard figure-ofeight wire. The purpose of the present study was to assess any advantages provided by 1.25-mm wire or an additional lateral wire over 1.0-mm wire for pin and tension-band fixation subjected to cyclic loading. Pin and tension-band fixation was applied to plastic olecranon osteotomy models with three wire configurations: 1.0-mm figure-of-eight, 1.25-mm figure-of-eight, and combined 1.0-mm figure-of-eight and lateral. Cyclic load was applied while caudal osteotomy displacement was measured with an extensometer. The three groups were compared in terms of cycles to failure, mean minimum displacement, mean maximum displacement, and mean displacement per cycle. Models with an additional lateral wire survived significantly more cycles than those with a solitary 1.0-mm figure-of-eight wire, although caudal osteotomy displacements were not significantly different. Conversely, models with 1.25-mm wire allowed significantly smaller minimum and maximum displacements than those with 1.0-mm wire, but did not survive significantly more cycles. It therefore appears that clinical use of 1.25-mm wire may improve stability, while use of an additional lateral wire may improve durability.
-
References
- 1 Halling KB, Lewis DD, Cross AR. et al. Complication rate and factors affecting outcome of olecranon osteotomies repaired with pin and tensionband fixation in dogs. Can Vet J 2002; 43: 528-34.
- 2 Henley MB. Intra-articular distal humerus fracture in adults. Orthop Clin North Am 1987; 18: 11-23.
- 3 Macko D, Szabo RM. Complications of tensionband wiring of olecranon fractures. J Bone Joint SurgAm 1985; 67: 1396-401.
- 4 Murphy DF, Greene WB, Dameron TB. Jr. Displaced olecranon fractures in adults. Clinical evaluation. Clin Orthop 1987; 224: 215-23.
- 5 Hume MC, Wiss DA. Olecranon fractures. A clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop 1992; 285: 229-35.
- 6 Neat BC, Kowaleski MP, Litsky AS. et al. Mechanical evaluation of pin and tension-band factors in an olecranon osteotomy model. Vet Surg 2006; 35: 398-405.
- 7 Fyfe IS, Mossad MM, Holdsworth BJ. Methods of fixation of olecranon fractures. An experimental mechanical study. J Bone Joint Surg Br 1985; 67: 367-72.
- 8 Halling KB, Lewis DD, Cross AR. et al. Biomechanical comparison of a circular external skeletal fixator construct to pin and tension band wire fixation for the stabilization of olecranon osteotomies in dogs: A cadaveric study. Vet Surg 2003; 32: 324-35.
- 9 Horner SR, Sadasivan KK, Lipka JM. et al. Analysis of mechanical factors affecting fixation of olecranon fractures. Orthopedics 1989; 12: 1469-72.
- 10 Hutchinson DT, Horwitz DS, Ha G. et al. Cyclic loading of olecranon fracture fixation constructs. J Bone Joint Surg Am 2003; 85: 831-7.
- 11 Kozin SH, Berglund LJ, Cooney WP. et al. Biomechanical analysis of tension band fixation for olecranon fracture treatment. J Shoulder Elbow Surg 1996; 5: 442-8.
- 12 Molloy S, Jasper LE, Elliott DS. et al. Biomechanical evaluation of intramedullary nail versus tension band fixation for transverse olecranon fractures. JOrthop Trauma 2004; 18: 170-4.
- 13 Mullett JH, Shannon F, Noel J. et al. K-wire position in tension band wiring of the olecranon – a comparison of two techniques. Injury 2000; 31: 427-31.
- 14 Murphy DF, Greene WB, Gilbert JA. et al. Displaced olecranon fractures in adults. Biomechanical analysis of fixation methods. Clin Orthop 1987; 224: 210-4.
- 15 Paremain GP, Novak VP, Jinnah RH. et al. Biomechanical evaluation of tension band placement for the repair of olecranon fractures. Clin Orthop 1997; 335: 325-30.
- 16 Petraco DM, Koval KJ, Kummer FJ. et al. Fixation stability of olecranon osteotomies. Clin Orthop 1996; 333: 181-5.
- 17 Prayson MJ, Williams JL, Marshall MP. et al. Biomechanical comparison of fixation methods in transverse olecranon fractures: a cadaveric study. J Orthop Trauma 1997; 11: 565-72.
- 18 Tejwani NC, Garnham IR, Wolinsky PR. et al. Posterior olecranon plating: biomechanical and clinical evaluation of a new operative technique. Bull Hosp Jt Dis 2002-2003 61: 27-31.
- 19 Wu CC, Tai CL, Shih CH. Biomechanical comparison for different configurations of tension band wiring techniques in treating an olecranon fracture. J Trauma 2000; 48: 1063-7.
- 20 Roe SC. Tension band wiring of olecranon fractures: a modification of the AO technique. Clin Orthop 1994; 308: 284-6.
- 21 Labitzke R. Theory of traction. Determination of the optimal arrangement of metal in the dorsal traction of an olecranon fracture. Arch Orthop Un-fallchir 1975; 81: 179-92.
- 22 Labitzke R, Towfigh H. Technic and results of lateral tension-band wiring of patella and olecranon-fractures. Unfallheilkunde 1980; 83: 450-6.
- 23 White DT, Bronson DG, Welch RD. Amechanical comparison of veterinary linear external fixation systems. Vet Surg 2003; 32: 507-14.
- 24 Marcellin-Little DJ, Roe SC, Rovesti GL. et al. Are circular external fixators weakened by the use of hemispheric washers?. Vet Surg 2002; 31: 367-74.
- 25 Ruedi TP, Murphy WM. AO principles of fracture management. Thieme, Stuttgart: 2000. pp 325.
- 26 McMaster-Carr Supply Catalog. On-Line Catalog. Document 8573KAC.
- 27 Mischler S, Pax G. Tribiological behavior of titanium sliding against bone. Eur Cells and Mat 2002; 3 Suppl 28-9.