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9Use of the articulated tension device

The articulated tension device

Application of the articulated tension device

It is strongly recommended to apply controlled compression to the metaphyseal fracture component using the articulated tension device when possible. This is usually the case in fracture patterns in which, after reduction, there is direct contact between the proximal and distal main fragments. There are certain fractures in which the articulated compression device can not be used. This most commonly is a severely comminuted, osteoporotic metaphyseal fracture. It must be stressed, however, that a fracture can be compressed along the lateral cortex (for example) even if there is significant medial comminution.

After the Verbrugge clamp is loosely applied, the articulated tension device is engaged in the proximal hole of the plate and fixed to the bone with a bicortical screw. An articulating wrench is then used to compress the fracture zone. When this occurs the strain gauge on the device goes from the green zone to the yellow zone and finally to the red zone. During the use of this wrench, the fracture complex must be monitored to ensure that no undesirable displacement occurs.