Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques
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The purpose of this retrospective study is to compare the clinical, functional outcome and complications occurrence between tension band wiring (TBW) and plate fixation both for simple and comminuted displaced olecranon factures.
Materials and methods
Between January 2005 and June 2012 (minimum 1-year follow-up), 78 consecutive patients with Mayo type IIA and IIB fractures were treated with the following methods: tension band wire or plate and screws fixation. The primary outcome of this study was the functional outcome, assessed by the following self-administered evaluation scales: the disabilities of the arm, shoulder and hand, and the Mayo Elbow Performance Score. Secondary outcome measures included the assessment of pain level, analysis of passive range of motion, and the occurrence of any early or late complications.
Comparing the clinical results between the two groups, at mean 33 months follow-up, no significant differences in the functional and clinical outcome were observed. Complications were reported in 48 and 17 % of cases, following TBW and plate fixation in patients treated for type IIA fractures, and similarly in 40 and 23 % of cases in type IIB fractures, respectively. Hardware removal was more frequently performed in TBW group: 38 versus 17 % for type IIA fractures and 20 versus 6 % for type IIB fractures.
The findings of this study indicate that both with the use of TBW and plate fixation excellent/good clinical outcomes with minimal loss of physical capacity, little pain and disability can be obtained in the majority of patients with simple and comminuted displaced olecranon fractures. Hardware removal was most frequently observed after TBW.
Level of evidence
KeywordsTension band wiring Plate fixation Olecranon fracture Mayo DASH Complications Outcome
Conflict of interest
All the authors declare that they have no conflict of interest.
- 22.Morrey BF, An KN, Chao EYS (1993) Functional evaluation of the elbow. In: Morrey BF (ed) The elbow and its disorders, 2nd edn. W.B. Saunders, Philadelphia, pp 86–89Google Scholar
- 36.Cabanella ME, Morrey BF (1993) Fractures of the proximal ulna and olecranon. In: Morrey BF (ed) The elbow and its disorders. W.B. Saunders, Philadelphia, pp 407–408Google Scholar
- 39.Tejwani NC, Garnham IR, Wolinsky PR, Kummer FJ, Koval KJ (2002–2003) Posterior olecranon plating: biomechanical and clinical evaluation of a new operative technique. Bull Hosp Jt Dis 61:27–31Google Scholar