A comparative study of outcome of tension band wiring and hook plating in fracture olecranon
DOI:
https://doi.org/10.18203/issn.2455-4510.IntJResOrthop20231176Keywords:
Olecranon fractures, Tension band wiring, Hook plating, Elbow injuryAbstract
Background: Olecranon fractures are common upper limb fracture accounting for 40% of the fractures around elbow. Anatomic reduction and restoration of the joint surface is required for good outcome and to prevent post-traumatic arthritis. This study was directed towards the functional results and complications of surgical management of olecranon fracture treated with hook plate fixation and tension band wiring.
Methods: This prospective comparative study was done at a tertiary care centre from 2019 to 2022. This study consisted of 30 patients of fracture olecranon of which 15 were treated with tension band wiring and 15 with hook plate. All patients were followed up with minimum follow up of six months and evaluated for their functional outcome using Mayo elbow performance score.
Results: In this study, the average age was 34 years in TBW group and 37 years in hook plate group. The mean Mayo elbow performance score after 6 months in TBW group was 88.33 (excellent) and in plate group was 90 (excellent). Superficial infection was present in 2 patients of the TBW group. Elbow stiffness was present in 2 patients of TBW group. Hardware impingement was present in one patient in each of TBW group and plate group.
Conclusions: To achieve early movements and to prevent complications like traumatic arthritis and joint stiffness we need a perfect anatomical reduction in intra-articular fractures of the olecranon. This study showed no significant difference in functional outcome with both the techniques, but the complications are more with TBW.
References
Tankshali K, Patel Z, Patel K, Shah A. Comparative study of different methods of olecranon fracture fixation. Panacea J Med Sci. 2017;7(2):58-61.
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.
Wiegand L, Bernstein J, Ahn J. Fractures in brief: Olecranon fractures. Clin Orthop Relat Res. 2012;470(12):3637-41.
Ahmed AR, 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. 2008;18:571.
Lu QF, Tang GL, Zhao XJ, Zhang WJ, Guo SG, Wang HZ. Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthop Traumatol Turc. 2015;49(6):654-60.
Bhattacharyya TD. Treatment of Transverse Olecranon Fractures: Comparison Between Tension band wiring And Transcortical Screw. IOSR- JDMS. 2016;15(9): 93-6.
Aher DK, Pandey SH, Alawa S, Pathak A. Evaluation of functional outcome of tension band wiring in olecranon fractures and factors affecting the overall functional outcome. Int J Orthop Sci. 2018;4(2):334-6.
Wolfgang G, Burke F, Bush D, Parenti J, Perry J, LaFollette B, et al. Surgical treatment of displaced olecranon fractures by tension band wiring technique. Clin Orthop Relat Res. 1987;(224):192-204.
Papagelopoulos PJ, Morrey BF. Treatment of nonunion of olecranon fractures. J Bone Joint Surg Br. 1994;76(4):627-35.
Gathen M, Jaenisch M, Peez C, Weinhold L, Schmid M, Welle K, et al. Plate fixation and tension band wiring after isolated olecranon fracture comparison of outcome and complications. J Orthop. 2019;18:69-75.
Ren YM, Qiao HY, Wei ZJ, Lin W, Fan BY, Liu J, et al. Efficacy and safety of tension band wiring versus plate fixation in olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res. 2016;11(1):137.
Gordon MJ, Budoff JE, Yeh ML, Luo ZP, Noble PC. Comminuted olecranon fractures: a comparison of plating methods. J Shoulder Elbow Surg. 2006;15(1):94-9.
Midtgaard KS, Søreide E, Brattgjerd JE, Moatshe G, Madsen JE, Flugsrud GB. Biomechanical comparison of tension band wiring and plate fixation with locking screws in transverse olecranon fractures. J Shoulder Elbow Surg. 2020;29(6):1242-8.
