Biomechanics of Tension Band Constructs for Fracture Fixation

  • Austin Edward MacDonald
  • Chetan Gohal
  • Herman JohalEmail author


Tension band constructs for fracture fixation have been used for decades and are based on fundamental biomechanical principles originally described by Frederich Pauwels. These contributed substantially to our understanding of the relationship between stress, load, and bone. Tension bands function by converting distraction forces into compressive forces that are evenly distributed across a fracture site, to create an environment favourable for fracture healing. While there are specific requirements for successful application of tension band principles, these constructs can be utilized for a variety of long bone and peri-articular fractures using a range of implants. A major advantage of tension band constructs is that they compress fracture surfaces to allow for early range of motion and weight-bearing and in turn help improve functional outcomes of the bones and joints affected. This chapter will review the essential biomechanical principles of tension band constructs and provide examples of their application.


Tension band Fracture Internal fixation Biomechanics Case examples 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Austin Edward MacDonald
    • 1
  • Chetan Gohal
    • 1
  • Herman Johal
    • 1
    Email author
  1. 1.Division of Orthopaedic Surgery, Department of SurgeryHamilton General Hospital, McMaster UniversityHamiltonCanada

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