Comparison of tension band wiring and plate fixation in Mayo type 2A olecranon fractures

Abstract

Objectives This study aims to compare clinically and functionally patients who had previously undergone tension band wiring (TBW) or plate fixation (PF) procedure due to the diagnosis of Mayo type 2A olecranon fracture in our clinic. Patients and methods Data of 92 patients (51 males, 41 females; mean age 42.3±12.6 years; range, 16 to 75 years) operated on for olecranon fractures between January 2014 and December 2018 were recorded retrospectively. Forty-four patients received TBW and 48 patients received PF treatment. Their Disabilities of the Arm, Shoulder, and Hand (DASH) and Mayo scores and elbow range of motion (ROM) measurements were used for clinical and functional evaluations. Data including the time to return to work, revision rate, and follow-up time were also recorded. Results The mean follow-up time was 38.2±17.2 months. Patients returned to work in 9.2±4.1 weeks in the TBW group and 7.8±3.6 weeks in the PF group (p=0.279). The revision rate was 14% in the TBW group and 2% in the PF group (p=0.335). The mean DASH score was 10.0±1.8 in the TBW group and 7.7±1.2 in the PF group (p=0.001). The mean Mayo score was 84.0±9.3 in the TBW group and 88.3±9.1 in the PF group (p=0.049). For elbow flexion-extension ROM, 4° of difference was measured in favor of the PF group (p=0.043). Mean Mayo score, mean DASH score, and mean flexion-extension ROM values were statistically significantly different between the two groups. Conclusion Both surgical techniques are suitable and reliable in the treatment of olecranon fractures. Although TBW treatment is low-cost and simple to apply, its biggest disadvantage is a high rate of secondary surgery for implant removal due to irritation of the skin.

Efficacy and safety of tension band wire versus plate for Mayo II olecranon fractures: a systematic review and meta-analysis

“…The other five studies compared the long-term efficacy of 1 year or more, while two CSs compared the efficacy of the Mayo II OF [ 15 , 16 ]. Besides, two CSs [ 18 , 25 ] and one RCT [ 17 ] compared the efficacy of the Mayo IIA OF. A better long-term MEPS was found in the plate group (MD = − 3.06; 95% CI − 5.50, 0.62; P = 0.01; I 2 = 41% ).…”

“…They were not included in the meta-analysis for unmentioned measuring time. In addition, two CSs [ 18 , 25 ] and one RCT [ 17 ] compared the long-term efficacy of the Mayo IIA OF for 1 year or more. Furthermore, the plate group showed better functional scores (MD: 2.32; 95% CI 1.91, 2.73; P < 0.00001; I 2 = 0%) (Fig.…”

“…They were not included in the meta-analysis for unmentioned measuring time. The other two studies compared the long-term elbow extension deficit of the Mayo IIA OF of 1 year or more [ 18 , 25 ]. Furthermore, there was no difference in postoperative elbow extension deficit between both groups (MD: 1.52°; 95% CI − 0.38, 3.42; P = 0.12; I 2 = 92%) (Fig.…”

“…Then, 41 articles were further excluded because of unqualified fracture classification, insufficient following time and no data on the outcome of interest. Finally, 11 articles, namely 1 RCT and 10 CSs, were involved [15][16][17][18][19][20][21][22][23][24]. Figure 1 presents the flow chart of the literature search and study selection.…”

“…Five studies reported postoperative Dash score (one RCT and four CSs) [17,18,22,23,25], while two CSs examined the Mayo II OF (Tarallo (MD: 1.70; 95% CI − 3.75, 7.15; P = 0.54) [23]) and the Mayo IIA OF (Schliemann (MD: 1.50; 95% CI − 7.28, 10.28; P = 0.74) [22]), respectively. There existed no statistical difference between Jia et al Journal of Orthopaedic Surgery and Research (2022) 17:373 both treatment groups, while the scores of the plate group were better than those of the TBW group in both studies.…”