Ali, M, Kuiper, JH and John, J (2016) Biomechanical analysis of tension band wiring (TBW) of transverse fractures of patella. Chinese Journal of Traumatology, 19 (5). pp. 255-258. ISSN 1008-1275

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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.

Item Type: Article
Additional Information: This is the accepted author manuscript (AAM). The final published version (version of record) is available online via Elsevier at Please refer to any applicable terms of use of the publisher.
Uncontrolled Keywords: Patella transverse fractures, Tension band wiring, Biomechanical analysis
Subjects: R Medicine > R Medicine (General)
Divisions: Faculty of Medicine and Health Sciences > Institute for Science and Technology in Medicine
Depositing User: Symplectic
Date Deposited: 13 Sep 2016 15:09
Last Modified: 31 Mar 2021 15:48

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