Olecranon tension plating or olecranon tension band wiring? A comparative biomechanical study
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The complication rate of a tension band wiring (TBW) used for the internal fixation of olecranon fractures remains high. The aim of this study was to compare the stability of a novel olecranon tension plate (OTP) with TBW in a simulated fracture model.
We tested 12 fresh frozen-pairs of cadaver proximal ulnae treated with OTP and TBW under cyclic loading. The elbow motion ranged from full extension to 90° of flexion, and the pulling force of the triceps tendon ranged from 50 to 350 N. The displacement of the fracture fragments was measured continuously. Data were assessed statistically using the Wilcoxon test with significance level of p < 0.05.
The cyclic loading tests showed median displacements of the fracture fragments of 0.25 mm using OTP and 1.12 mm for TBW. Statistical analysis showed the difference to be substantial (p = 0.086) but not statistically significant. No plate breakage or screw loosening occurred.
The concept of replacing prominent K-wires at the proximal end of the ulna using an low-profile plate with classical lag and multidirectional angle-stable screws demonstrated biomechanical advantages over TBW.
KeywordsTension band wiring Olecranon fracture Olecranon tension plate Biomechanical study Olecranon fixation
No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this study by any of the authors.
The biomechanical laboratory of the Department of Trauma Surgery is supported by a yearly grants from Medartis AG, Basel, Switzerland.