Tension wire fixation of avulsion fractures in the hand

Tension band wiring is a simple, predictable method of internal fixation for avulsion fracture in the hand. These fractures include the bony gamekeeper, bony mallet, and fractures associated with proximal interphalangeal joint trauma. By the placement of a small gauge wire through the insertion of the ligament or tendon onto the fracture fragment, the tension wire technique avoids many of the pitfalls of internal fixation and also takes advantage of its physiologic and biomechanical position.