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Transverse fractures of the olecranon: a biomechanical comparison of three fixation techniques

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Abstract

Introduction

The gold standard for treating transverse olecranon fractures is tension band fixation. A problem with this technique is migration of the K-wires leading to premature hardware removal. The aim of this study is to compare stability provided by two new techniques designed to eliminate the problem with backing out of K-wires, with that of the recommended tension band technique, performed with a biomechanical in vitro investigation. Our hypothesis was that the two new techniques would provide at least equal stability as the traditional tension band fixation.

Methods

Transverse olecranon osteotomies were created in human cadaveric elbows to simulate a type 21-B1.1 fracture. Three groups of 8 specimens were instrumented with: (1) recommended AO tension band technique; (2) modified K-wires with eyelets and tension band; (3) staples across the fracture with tension band. Each elbow was tested in a 90° flexed position. The triceps tendon was sinusoidally loaded by applying two load steps at 500 and 700 N for 4000 cycles each. Relative movements between the fragments were determined.

Results

At the end of the first and second load step the displacement of the osteotomy at the posterior ulnar side was significantly less for the staples across the fracture with tension band as compared to both other groups. There were no significant differences between groups 1 and 2.

Conclusion

Since clinical results depend partly on stable fixation, it is concluded that using staples in the clinical situation might provide better results than the currently recommended tension band technique.

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Acknowledgments

The authors wish to thank Synthes Inc. for the provision of the implants and instruments.

Conflict of interest

The authors have an affiliation with the AO Foundation which is partly funded by non-directed and unrestricted royalties from licenses granted to Synthes Inc. The authors are not compensated and there are no other institutional subsidy, corporate affiliations, or funding sources supporting this work.

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Authors and Affiliations

  1. University Hospital Geneva, 24 Rue Micheli-du-Crest, 1211, Geneva 14, Switzerland

    Hassan Sadri, Richard Stern, Michael Singh & Pierre Hoffmeyer

  2. AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos, Switzerland

    Berend Linke & Karsten Schwieger

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  1. Hassan Sadri
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  2. Richard Stern
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  3. Michael Singh
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  4. Berend Linke
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  6. Karsten Schwieger
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Correspondence to Karsten Schwieger.

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Sadri, H., Stern, R., Singh, M. et al. Transverse fractures of the olecranon: a biomechanical comparison of three fixation techniques. Arch Orthop Trauma Surg 131, 131–138 (2011). https://doi.org/10.1007/s00402-010-1156-6

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  • DOI: https://doi.org/10.1007/s00402-010-1156-6

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