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The role of cancellous screw with tension band fixation in the treatment of displaced olecranon fractures, a comparative study

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Abstract

Introduction

Fractures of the olecranon are among the most common injuries involving the upper extremity and require operative intervention if displaced. The most commonly used method of fixation for this type of fracture is the AO tension band wiring, although the results of this technique have been generally good, still problems have occurred, including loss of fixation, nonunion, and high re-operation rate for hardware removal.

Aim of the study

To compare the results of treatment of displaced fractures of the olecranon using AO tension band wiring versus intramedullary screw with tension band.

Materials and methods

In a prospective study, 30 patients with transverse or oblique olecranon fractures, were randomly divided into two equal groups, one group treated using AO tension band wiring the other group using an intramedullary cancellous screw plus tension band.

Results

In the screw plus tension band group, 11 (73.3%) patients had excellent results, four (26.7%) had good results and none had fair or poor results, only one(6.6%) patient required second operation for removal of prominent hardware. In the AO tension band group, six (40%) patients had excellent results, five (33.3%) had good, three (20%) had fair and one (6.7%) patient had poor result, and eight patients (53.3%) required second operation for removal of prominent hardware.

Conclusion

Using an intramedullary screw combined with tension band in treatment of displaced transverse and oblique olecranon fractures gives better clinical results and has much less re-operation rate for removal of hardware when compared to AO tension band wire fixation, avoiding costs, work time loss and possible complications from hardware removal.

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References

  1. Hak DJ, Golladay GJ (2000) Olecranon fractures: treatment options. J Am Acad Orthop Surg 8:266–275

    PubMed  CAS  Google Scholar 

  2. Papagelopoulos PJ, Morrey BF (1994) Treatment of nonunion of olecranon fractures. J Bone Joint Surg 76-B:627–635

    Google Scholar 

  3. Amis AA, Miller JH (1995) The mechanisms of elbow fractures: an investigation using impact tests in vitro. Injury 26:163–168

    Article  PubMed  CAS  Google Scholar 

  4. Fyfe IS, Mossad MM, Holdsworth BJ (1985) Methods of fixation of olecranon fractures. An experimental mechanical study. J Bone Joint Surg 67-B:367–372

    Google Scholar 

  5. Murphy DF et al (1987) Displaced olecranon fractures in adults. Biomechanical analysis of fixation methods. Clin Orthop Relat Res 224:210–214

    PubMed  Google Scholar 

  6. Horner SR et al (1989) Analysis of mechanical factors affecting fixation of olecranon fractures. Orthopedics 12:1469–1472

    PubMed  CAS  Google Scholar 

  7. Rowland SA, Burkhart SS (1992) Tension band wiring of olecranon fractures. A modification of the AO technique. Clin Orthop Relat Res 277:238–242

    PubMed  Google Scholar 

  8. Heim U, Pfeiffer K (1974) Small fragment set manual: technique recommended by the ASIF-Group. Springer, New York, p 743

    Google Scholar 

  9. Murphy DF, Greene WB, Dameron TB (1987) Displaced olecranon fractures in adults. Clinical evaluation. Clin Orthop Relat Res 224:215–223

    PubMed  Google Scholar 

  10. Hutchinson DT et al (2003) Cyclic loading of olecranon fracture fixation constructs. J Bone Joint Surg 85-A:831–837

    PubMed  Google Scholar 

  11. Wolfgang G et al (1987) Surgical treatment of displaced olecranon fractures by tension band wiring technique. Clin Orthop Relat Res 224:192–204

    PubMed  Google Scholar 

  12. Inglis AE, Pellicci PM (1980) Total elbow replacement. J Bone Joint Surg 62-A:1252–1258

    Google Scholar 

  13. Gartsman GM, Sculco TP, Otis JC (1981) Operative treatment of olecranon fractures. Excision or open reduction with internal fixation. J Bone Joint Surg 63-A:718–721

    Google Scholar 

  14. Eriksson E, Sahlin O, Sandahl U (1957) Late results of conservative and surgical treatment of fracture of the olecranon. Acta Chir Scand 2:153–166

    Google Scholar 

  15. Horne JG, Tanzer TL (1981) Olecranon fractures: a review of 100 cases. J Trauma 21:469–472

    PubMed  CAS  Google Scholar 

  16. Kiviluoto O, Santavirta S (1978) Fractures of the olecranon. Analysis of 37 consecutive cases. Acta Orthop Scand 1:28–31

    Google Scholar 

  17. Rettig AC, Waugh TR, Evanski PM (1979) Fracture of the olecranon: a problem of management. J Trauma 19:23–28

    Article  PubMed  CAS  Google Scholar 

  18. Chapman MW, Mahoney M (1979) The role of early internal fixation in the management of open fractures. Clin Orthop Relat Res 138:120–131

    PubMed  Google Scholar 

  19. Romero JM, Miran A, Jensen CH (2000) Complications and re-operation rate after tension-band wiring of olecranon fractures. J Orthop Sci 5:318–320

    Article  PubMed  CAS  Google Scholar 

  20. Macko D, Szabo RM (1985) Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg 67A:1396–1401

    Google Scholar 

  21. Deliyannis SN (1973) Comminuted fractures of the olecranon treated by the Weber-Vasey technique. Injury 5:19–24

    Article  PubMed  CAS  Google Scholar 

  22. Müller M et al (1991) Manual of internal fixation: techniques recommended by the AO-ASIF group, 3rd edn. Springer, Berlin

    Google Scholar 

  23. Scharplatz D, Allgower M (1975) Fracture-dislocations of the elbow. Injury 7:143–159

    Article  PubMed  CAS  Google Scholar 

  24. Colton CL (1973) Fractures of the olecranon in adults: classification and management. Injury 5:121–129

    Article  PubMed  CAS  Google Scholar 

  25. Morrey BF (1995) Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid. Instr Course Lect 44:175–185

    PubMed  CAS  Google Scholar 

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Conflict of interest statement

No funds were received in support of this study

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Correspondence to Adel Refaat Ahmed.

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Ahmed, A.R., Sweed, T. & Wanas, A. The role of cancellous screw with tension band fixation in the treatment of displaced olecranon fractures, a comparative study. Eur J Orthop Surg Traumatol 18, 571–576 (2008). https://doi.org/10.1007/s00590-008-0355-0

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  • DOI: https://doi.org/10.1007/s00590-008-0355-0

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