Tension Band Wiring

What is the biomechanical principle behind Tension Band Wiring (TBW) for olecranon fractures?

• Converts compression into tension during extension

• Converts anterior shear into rotation

• Converts posterior tensile forces into anterior compression during flexion

• Prevents bone elongation during extension

Which of the following is an indication for TBW in olecranon fractures?

• Comminuted fractures

• Osteoporotic bone

• Transverse or short oblique fractures

• Distal shaft fractures

Which is a contraindication for Tension Band Wiring?

• Isolated olecranon fracture

• Short oblique fracture

• Comminuted fracture

• Good bone quality

What is the recommended size of the K-wires used in TBW?

• 1.0 mm

• 1.6 mm

• 2.5 mm

• 0.8 mm

Where should the K-wires be inserted during TBW surgery?

• Through the ulna shaft only

• Anterior to the fracture line

• From the olecranon tip to the anterior cortex

• Parallel to the humerus shaft

What type of wire configuration is used in TBW technique?

• Circular loop

• Figure-of-eight

• Z-shaped suture

• Straight cerclage

Which patient positioning is appropriate for TBW surgery?

• Prone with medial access

• Seated with elbow extended

• Supine with posterior access or lateral position

• Standing with arm hanging

Which of the following is a potential complication of TBW?

• Bone overgrowth

• K-wire migration

• Tendon rupture

• Nerve regeneration

When is early range of motion (ROM) usually started after TBW surgery?

• After 6 weeks

• Immediately post-op

• After 1–2 weeks once wound has healed

• After 4 months

Why is TBW considered the gold standard for simple olecranon fractures?

• It avoids surgery completely

• Provides stable fixation and allows early rehabilitation

• Only requires external fixation

• Works best for comminuted fractures