Olecranon fractures in the elderly. Is tension band wiring the right treatment?

Background and Aims: The incidence of olecranon fractures is rising. Displaced fractures are usually operated either by tension band wiring or plate fixation. The aim of this review is to evaluate the best current evidence on the management of displaced olecranon fractures. Materials and Methods: Randomized controlled trials were systematically gathered in May 2018 from CENTRAL, MEDLINE, Embase, CINAHL, Scopus, and PEDro databases. The methodological quality of articles was assessed according to the Cochrane Collaboration’s domain-based framework. Prospero database registration number: CRD42018096650. Results: Of 1518 identified records, finally, 5 were relevant. Four trials were found on tension band wiring: two compared tension band wiring with plate fixation (n = 108), one compared plate fixation with an olecranon memory connector (n = 40), and one trial compared tension band wiring with a modified tension band wiring called Cable Pin System (n = 62). In addition, one trial compared operative and conservative treatment in elderly (n = 19). The risk of bias was considered low in two and high in three of the trials. The follow-up time was 5–36 months, and outcome measures varied from patient-rated and physician-rated measures to radiological outcomes. In the analysis, there was no difference between tension band wiring and plate fixation. The data were insufficient for further quantitative analysis. Conclusion: No differences were found in clinical or patient-rated outcome measures between the two most frequent fixation methods (tension band wiring and plate fixation) of displaced olecranon fractures. Current data are not sufficient to evaluate other treatment methods; however, conservative treatment might serve as an option for selected patients in the elderly population.

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Suture Fixation Versus Tension Band Wiring of Simple Displaced Olecranon Fractures

Case Medical Research ◽

10.31525/ct1-nct04189185 ◽

2019 ◽

Author(s):

Keyword(s):

Tension Band ◽

Tension Band Wiring ◽

Suture Fixation ◽

Olecranon Fractures

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Complications and re-operations related to tension band wiring and plate osteosynthesis of olecranon fractures

Journal of Shoulder and Elbow Surgery ◽

10.1016/j.jse.2021.03.138 ◽

2021 ◽

Author(s):

Ida K. Rantalaiho ◽

Inari E. Laaksonen ◽

Anssi J. Ryösä ◽

Katariina Perkonoja ◽

Kari J. Isotalo ◽

...

Keyword(s):

Plate Osteosynthesis ◽

Tension Band ◽

Tension Band Wiring ◽

Olecranon Fractures

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Patient positioning for tension band wiring of olecranon fractures

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2018.0142 ◽

2019 ◽

Vol 101 (3) ◽

pp. 228-229

Author(s):

A Patel ◽

K Shepherd ◽

K Karthik

Keyword(s):

Patient Positioning ◽

Tension Band ◽

Tension Band Wiring ◽

Olecranon Fractures

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Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

International Journal of Research in Orthopaedics ◽

10.18203/issn.2455-4510.intjresorthop20203723 ◽

2020 ◽

Vol 6 (5) ◽

pp. 1012

Author(s):

Lokesh Kumar Yogi ◽

Gagandeep Mahi ◽

C. R. Thorat ◽

Moti Janardhan Naik

Keyword(s):

Functional Outcome ◽

Large Scale ◽

Plate Fixation ◽

Tension Band ◽

Tension Band Wiring ◽

Clinical Event ◽

Dash Score ◽

Group A ◽

Group B ◽

Olecranon Fractures

Background: Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.Methods: A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.Results: Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.Conclusions: The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results.

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Intramedullary screw fixation for simple displaced olecranon fractures

European Journal of Trauma and Emergency Surgery ◽

10.1007/s00068-019-01114-4 ◽

2019 ◽

Vol 46 (1) ◽

pp. 83-89 ◽

Cited By ~ 1

Author(s):

Willem-Maarten P. F. Bosman ◽

Benjamin L. Emmink ◽

Abhiram R. Bhashyam ◽

R. Marijn Houwert ◽

Jort Keizer

Keyword(s):

Soft Tissue ◽

Plate Fixation ◽

Cannulated Screw ◽

Tension Band ◽

Tension Band Wiring ◽

Hardware Removal ◽

Dash Score ◽

Intramedullary Screw ◽

Olecranon Fractures

Abstract Purpose Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. Methods We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). Results By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. Conclusions Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.

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