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Combination of double tension band fixation for the treatment of humerus fractures


Kirschner wire bending big capacity. Eliminate TianjinMedJ,[link widoczny dla zalogowanych], Aug2005, Vol33No8 the stump separation and the fixed performance has improved significantly. In addition, when used in conjunction with the condylar screw, the medial and lateral columns at the same time tension band fixation can improve the overall fracture rotational stability, a good fixed so that the joints can withstand early postoperative functional exercise I21. (2) treatment is more consistent with biological principles. After the pinning only the exposed needle end. For linear wire fixation, the basic operation of the original within the periosteal injury, almost no soft tissue dissection,[link widoczny dla zalogowanych], it is possible to preserve the surrounding bone and joint blood flow, compared with the plate and screw fixation, posterior elbow retention within the plant to reduce the volume can reduce wound tension and the chances of infection. (3) the method can be applied to ask the majority of humeral fractures, especially some of the difficulties of low plate fracture type. HoubenI21 application of this law treatment of nonunion of fractures, that this method does not apply to severe comminuted fracture; but I and others reported that I51 has been successfully applied to many cases of patients with comminuted fracture of type c3. (4) The method is simple, easy to learn, if and olecranon articular oblique osteotomy alone units in acute and primary application. (5) Fixed method is more flexible. Restitution in the fracture process. Such as plate and screw fixation is expected to be difficult or unstable fixed. Can be fixed based on the original installation of the temporary Kirschner wire and tension band loop to become permanently fixed to complete the form of improved surgical methods optional. (6) the application of the method should note the following: ① Kirschner wire into the needle should be in the best direction of the vertical cross section of bone at the same time, to rebuild the structural stability of the medial and lateral columns as the main purpose and pins to be through internal and external condyle, condylar and on the proximal metaphyseal (Figure 1). ② preoperative, intraoperative estimated by vertical extrusion, the lateral column fracture instability occurs is not suitable for this method (Figure 3). ③ seriously pintail, pintail prominent, flip and exit is the talk of potential problems after surgery, to facilitate the bending pin tail,[link widoczny dla zalogowanych], should use the following 2lnln diameter Kirschner wire, the tip will be through the opposite cortical bone, and cortical bone protruding from the tip to the opposite direction of bending the backbone of a few degrees,[link widoczny dla zalogowanych], to prevent needle tail exit. (See inset Figure 2.3)