[Tension band osteosynthesis--a method fraught with complications in surgical fracture treatment?]

Tension-band osteosynthesis is a simple and well-known procedure in the surgical treatment of fractures. An analysis of 180 patients, operated on in our hospital or admitted for corrective osteosynthesis, showed 23 mistakes of a minor degree and 20 major mistakes. Malpositioning of K-wires or cerclages caused the minor mistakes. Loosening of metal, failure of osteosynthesis or poor adaptation of fragments were responsible for the major mistakes. Tension-band osteosynthesis can only be successful if the principles of biomechanics are realised, if tension forces are transmitted by the implant, if bony buttressing is achieved by the fragments, and if torsion forces are converted into compressive forces (Pauwels).