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Theory of Tension Band Wiring

- Theory of Tension Band:
    - anterior tension band wiring intentionally creates a small separation of surface of patellar articular surface w/ knee in extension;
    - as knee goes into flexion, frx gap at the patellar articular surface closes down;
         - this occurs as tension forces of extensor mechanism are converted to compressive forces by anterior tension band wire;
    - Magnusson technique:
         - at the medial and lateral borders of the patella, drill holes in a superior to distal direction across the reduced patella;
         - an 18 gauge wire is passed thru these holes and is tightened either on the medial or lateral sides;
    - standard tension band wiring:
         - 18 gauge wire is passed deep to the quadriceps, brought over anterior surface of the patella, inserted into deep aspect of patellar 
                  tendon,and is then brought back across anterior surface of the patella;
         - wire is then tightened, so that there is slight overcorrection or an opening of the articular surface;
         - 2nd wire is inserted thru horizontal drills holes made in super and inferior poles of the patella, w/ both arms of the wire passed 
         - w/ the standard technique, the knee must be immobilized in flexion

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