ISSN 2398-2950      

Fracture fixation: wire

ffelis

Synonym(s): Cerclage, tension band, Kirschner, K wire


Introduction

  • To stabilize a fracture Fracture: overview using stainless steel wire until healing Fracture: healing is complete.
  • Three main methods are used:
  • Cerclage.
  • Kirschner (K wire).
  • Tension band.

Uses

Cerclage

  • Few practical applications.
  • In conjunction with other methods of fixation, eg IM pin Fracture femur 05: repair IM pin cerclage and type I external fixator not tied in , plate.
  • Treatment of mandibular symphyseal separations .
  • Treatment of certain mandibular/maxillary fractures.
  • Longitudinal, oblique or spiral fractures of diaphysis. Obliquity of fracture must be >1.5-2 times diameter of bone at fracture site.
    Never use alone in long bone fractures.
  • Use only when fracture fragments can be anatomically reduced.

K wire

  • Physeal fractures - young animals; as cross pins or two intramedullay pins.
  • In conjunction with other methods of fixation to resist rotational forces, shearing etc Fracture femur 01: repair intramedullary X-wire pins - CrCd view - radiograph .
  • As part of tension band method Fracture distal radius and ulna styloid 01: repair T plate and pin with figure of eight tension band .
  • During fracture reduction as temporary fixation for fragments.

Tension band

  • Fractures where compression can be achieved by providing resistance to muscle/tendon/ligament distractive forces, eg avulsion fractures: olecranon fracture, malleolar hock fracture; ie tensile forces of muscle, tendon ligament are converted into compressive forces at the fracture site.

Advantages

  • Relatively inexpensive.
  • Relatively quick procedure.
  • Minimal soft tissue dissection.

Disadvantages

Cerclage

  • Single wires may   →   stress concentration.
  • Alone are rarely strong enough to resist forces acting on fracture site.

K wire

  • Bend easily.
  • Often migrate - will probably need removing after fracture healing.

Tension band

  • Overlying soft tissues may interfere with the application of this technique.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Good when correctly applied.

Further Reading

Publications

Refereed papers

Related Images

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