Background
Tension band wire fixation techniques for fractures are well described in the literature and widely employed in clinical practice. We describe a technique that uses tension band principles to aid in maintaining the reduction of transverse femoral fractures, thereby simplifying the definitive intramedullary fixation.
Technique
Using a direct lateral approach as for an open reduction of the fracture, two 4.5 mm unicortical screws are inserted, one either side of the fracture site. A Dall-Miles cable or equivalent can then be applied and tensioned to reduce and hold the fracture reduced while intramedullary nail fixation is undertaken (Fig 1). This construct can then be left in or removed at the surgeon’s discretion.
Figure 1.
Discussion
This a very simple and powerful technique for providing temporary femoral fracture stabilisation enabling a much simpler intramedullary nail fixation in potentially difficult cases. We have found this technique particular useful in non-union cases that required a shortening osteotomy.