H.27 Tension band fastener

One fixation technique used commonly in orthopaedics is called a tension band. In this fixation construct, a 18 gauge stainless steel wire is passed around a fracture site and twisted around itself to generate tension. That tension then helps compress the fracture to promote healing. One issue with this otherwise very appealing fixation technique is the difficulty of appropriately tensioning the wire while twisting it around itself. It is easy to undertension the wire and thus not generate sufficient compression across the fracture, but it is also easy to over-tension the wire, causing it to break and thus having to repeat the exercise.

Tension bands are conventionally twisted for tension simply using a pair of pliers or similar instruments, but this rudimentary approach to tensioning the wires is a large part of the difficulty of performing this technique well; significant skill and experience is required to develop adequate tension to compress the fracture without breaking the wire.

The goal of this project is to develop a torque-limited set of wire-twist pliers which can reliably and easily twist the tension band wire to compress the fracture without over-tensioning the wire to the extent that it breaks.

The link below describes a common construct for tension band fixation of olecranon fixation, using the conventional technique of regular pliers to tension the wire:
https://surgeryreference.aofoundation.org/orthopedic-trauma/adult-trauma/proximal-forearm/ulna-articular-olecranon/tension-band-wiring#tension-band-principles

In the proposed project, the team will develop a tool, perhaps a torque-limited version of safety wire pliers used in aerospace applications, which can tension an 18 gauge wire around itself reliably without breaking the wire.