Tension Banding, Cerclage Wires and Cables in Management of Fractures

Abstract

Tension band wiring is one of the most effective and simple way of internal fixation for treating specific fractures. It works on the principle of converting the tension force into compressive force across the fracture site. It can be done in many fractures, most commonly olecranon in upper limb, patella fractures, and malleoli fracture in lower extremity. The most common materials used are stainless steel wires or cables or nonabsorbable sutures like fiber wires. Tension band construct or cerclage wiring sometimes can be employed to augment with other forms of fixation to improve the stability of fracture depends upon its complexity. Cerclage wires are commonly done in stabilization of diaphyseal long bone fractures with spiral or long oblique pattern. It is an augmenting fixation with distinct advantages like less periosteal stripping, early mobilization, technically less demanding surgery, and a cost-effective procedure. The main drawback of tension band wiring or cerclage wiring includes implant prominence, local pain, implant breakage, fracture displacements, and wound dehiscence. However, tension band wiring produces excellent and reliable outcomes following the management of specific fractures when the correct techniques are followed.