Complications and re-operation rate after tension-band wiring of olecranon fractures

Romero, Javier Martínez; Miran, André; Jensen, Claus Hjorth

doi:10.1007/s007760070036

Cited by 132 publications

(112 citation statements)

References 12 publications

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“…However, the findings in this study demonstrate that the incidence of complications differs postoperatively for TB and ORIF. Whereas similar types of complications arise after both TB and ORIF, including infection, nonunion, and hardware prominence, this study found that complication rates were significantly higher after TB ORIF open reduction internal fixation, OR odds ratio, CI confidence interval compared with ORIF [7,9]. After controlling for demographic factors, the relationship between TB and increased incidence of complications remained evident-a trend that may lead to increased overall risks and cost of care for patients who undergo TB.…”

Section: Discussionmentioning

confidence: 57%

“…Whereas open reduction internal fixation (ORIF) is considered the most effective treatment for comminuted olecranon fractures, there is debate about whether TB or ORIF is more effective for treating simple fracture patterns [5]. Previous studies comparing rates of re-operation following TB and ORIF of olecranon fractures have yielded equivocal results [6][7][8]. For both types of fixation, the most common postoperative complications leading to re-operation include arthrosis, infection, ulnar neuritis and symptomatic hardware issues requiring removal [8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

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Olecranon fractures: factors influencing re-operation

Snoddy

Lang

et al. 2014

International Orthopaedics (SICOT)

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Purpose We evaluated factors influencing re-operation in tension band and plating of isolated olecranon fractures. Methods Four hundred eighty-nine patients with isolated olecranon fractures who underwent tension band (TB) or open reduction internal fixation (ORIF) from 2003 to 2013 were identified at an urban level 1 trauma centre. Medical records were reviewed for patient information and complications, including infection, nonunion, malunion, loss of function or hardware complication requiring an unplanned surgical intervention. Electronic radiographs of these patients were reviewed to identify Orthopaedic Trauma Association (OTA) fracture classification and patients who underwent TB or ORIF. Results One hundred seventy-seven patients met inclusion criteria of isolated olecranon fractures. TB was used for fixation in 43 patients and ORIF in 134. No statistical significance was found when comparing complication rates in open versus closed olecranon fractures. In a multivariate analysis, the key factor in outcome was method of fixation. Overall, there were higher rates of infection and hardware removal in the TB compared with the ORIF group. Conclusions Our results demonstrate that the dominant factor driving re-operation in isolated olecranon fractures is type of fixation. When controlling for all variables, there is an increased chance of re-operation in patients with TB fixation.

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Section: Discussionmentioning

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Olecranon fractures: factors influencing re-operation

Snoddy

Lang

et al. 2014

International Orthopaedics (SICOT)

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“…Furthermore, hardware removal seems not always to be a panacea for symptoms resolution as 59% of TBW removals in our series were still complaining for mild pain or discomfort. Romero et al 13 noted that backing-out of K-wires and metalwork prominence could not justify alone the need for TBW removal and they should …”

Section: Discussionmentioning

confidence: 99%

Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate?

Chan

Donnelly

2015

Journal of Orthopaedics

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Methods: All patients who underwent TBW for an isolated olecranon fracture in our trauma unit between 1/1/2009 and 31/12/2011 were included in this retrospective study. Mean followup was 14 months (range 5e29 months). Data was gathered from medical records and radiographs. The outcome measured was removal of metal due to complications such as wound problems or proximal migration of wires as standard practice within out trauma unit.Results: Sixty-three patients met the inclusion criteria. Forty-seven had an intramedullary compared with 16 with transcortical configuration (ratio 3:1). Nine patients (19%) with intramedullary K-wires required removal of metalwork e seven due to prominent metalwork and two with wound infection. Four patients (25%) with transcortical K-wires required removal of metalwork e three due to prominent metalwork and one with failure of metalwork. There was no significant statistical difference between transcortical and intramedullary K-wire placement with regards to complication rates following tension band wiring of an isolated olecranon fracture requiring removal of metal (Chi squared test with Yates' correction p ¼ 0.89). Conclusion:We concluded that we found no difference in complications or metalwork removal rate in the placement of K-wire in tension band wiring for isolated olecranon fracture. We recognise our study was limited by small numbers and is based on the experience of one trauma unit.

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“…Most displaced olecranon fractures are treated with open reduction and internal fixation (ORIF). Tension band wiring remains the most commonly used method of internal fixation, although other methods of fixation are being used such as low-profile plating, intramedullary screw fixation, and locked intramedullary nailing [1,2,4,7,9]. But reoperations complicate the care of many (and in some series, most) patients treated with ORIF for olecranon fractures [3-5, 7, 12].…”

mentioning

confidence: 99%

“…The factors resulting in these reoperations are not fully understood, and could be related to the fractures, the patients, or the implants used. Several reports [7,[9][10][11] identified different factors associated with reoperations including prominent hardware, arthrosis, infection, ulnar neuropathy, and older age. Efforts to reduce the frequency of these reoperations have focused on techniques to eliminate or reduce hardware prominence and wire migration such as the use of low profile plates and intramedullary implants [1,2,[4][5][6]8]; these efforts have met with only mixed success.…”

mentioning

confidence: 99%

CORR Insights®: Factors Associated with Reoperation after Fixation of Displaced Olecranon Fractures

Naam

2016

Clinical Orthopaedics &Amp; Related Research

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Complications and re-operation rate after tension-band wiring of olecranon fractures

Cited by 132 publications

References 12 publications

Olecranon fractures: factors influencing re-operation

Olecranon fractures: factors influencing re-operation

Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate?

CORR Insights®: Factors Associated with Reoperation after Fixation of Displaced Olecranon Fractures

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