Tension band wiring used for a transverse fracture of the olecranon works on the principle that it:

• A Neutralises rotational forces acting on the proximal ulna
• B Converts the tensile forces generated by triceps pull into compressive forces across the fracture site ✓
• C Provides buttress support against axial loading of the elbow
• D Acts as a dynamic compression plate along the subcutaneous border of the ulna

Explanation

In a transverse olecranon fracture the triceps pulls the proximal fragment, creating tension on the posterior surface. B figure-of-eight wire placed on the tension side converts this distracting tensile force into interfragmentary compression when the wire is tightened, allowing early movement. The same principle applies to transverse patella fractures where the quadriceps creates tension on the anterior surface. It is a form of relative-to-absolute force conversion, not a buttress device.

Reference: Miller's Review of Orthopaedics, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.