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


  • Lokesh Kumar Yogi Department of Orthopedics, Government Medical College and Hospital Aurangabad, Maharashtra, India
  • Gagandeep Mahi Department of Orthopedics, Government Medical College and Hospital Aurangabad, Maharashtra, India
  • C. R. Thorat Department of Orthopedics, Government Medical College and Hospital Aurangabad, Maharashtra, India
  • Moti Janardhan Naik Department of Orthopedics, Government Medical College and Hospital Aurangabad, Maharashtra, India



Transverse displaced olecranon fracture, TBW, PF


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.


Rommens PM, Küchle R, Schneider RU, Reuter M. Olecranon fractures in adults: factors influencing outcome. Injury. 2004;35:1149-57.

Nieto H et al. Proximal ulnar fractures in adults: a review of 163 cases. Injury. 2015;46:S18-23.

Bernstein J, Monaghan BA, Silber JS, DeLong WG. Taxonomy and treatment: a classification of fracture classifications. J. Bone Joint Surg. Br. 1997;79:706-7.

Morrey BF. Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid. Instr. Course Lect.1995;44:175-85.

Duckworth AD, Clement ND, McEachan JE, White TO, Court-Brown CM, McQueen MM. Prospective randomised trial of non-operative versus operative management of olecranon fractures in the elderly. Bone Joint J. 2017; 99-B (7):964-72.

Colton CL. Fractures of the olecranon in adults: classification and management. Injury. 1973;5(2):121-9.

Anderson ML, Larson AN, Merten SM, Steinmann SP. Congruent elbow plate fixation of olecranon fractures, J. Orthop. Trauma. 2007;21(6)386-93.

Duckworth AD, Clement ND, Aitken SA, Court-Brown CM, McQueen MM. The epidemiology of fractures of the proximal ulna. Inj.Int J Care Inj. 2012;43(3):343-6.

Cusick MC, Bonnaig NS, Azar FM, Mauck BM, Smith RA, Throckmorton TW. Accuracy and reliability of the Mayo Elbow Performance Score. J Hand Surg Am. 2014;39(6):1146-50.

Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med. 1996;29:602-8.

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

Liu QH et al. Randomized prospective study of olecranon fracture fixation: cable pin system versus tension band wiring. J Int Med Res. 2012;40(3):1055-66.

Tarallo L, Mugnai R, Adani R, Capra F, Zambianchi F, Catani F. Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques. Arch Orthop Trauma Surg. 2014;134(8):1107-14.

Duckworth AD, Clement ND, White TO, Court-Brown CM, McQueen MM. Plate versus Tension-Band Wire Fixation for Olecranon Fractures: A Prospective Randomized Trial. J Bone Joint Surg Am. 2017;99(15):1261-73.

Yi-Ming Ren et al. Efficacy and safety of tension band wiring versus plate fixation in olecranon fractures: a systematic review and meta-analysis. Ren et al. J Orthop Sur Res. 2016;11:137.

Newman SDS, Mauffrey C, Krikler S. Olecranon fractures. Injury, Int. J. Care Injured .2009; 575-81.

Chan KW, Donnelly KJ. Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate? J Orthop. 2014;12(2):111-7.






Original Research Articles