This is a form of hemicerclage wiring used in

conjunction with Steinmann pins or Kirschner

wires. It is used to repair fractures or osteotomies
of traction apophysis (olecranon, greater trochanter
of the femur, greater tubercle of the humerus, tibial
tuberosity, acromion process of the scapula, etc.)
or other fractures which are under dynamic tensile
distractive forces (patellar fractures).

Fractures (osteotomies) amenable to tension band fixation

 The tension band principle converts
distractive forces to compressive forces
during muscular contraction and weight-
bearing.

The technique of tension band wiring is

similar regardless of the location where it is
employed. A transverse hole is drilled
through the metaphyseal or diaphyseal
cortex at a distance from the fracture line
equal to or greater than the distance from
the fracture line to the tip of the apophysis.
The fracture is reduced and two small
Steinmann pins or Kirschner wires are
driven across the fracture line. These
Tension band effect
should be parallel to each other and
perpendicular to the fracture line.

Application of a tension band