Functional Outcomes Following Plating or Tension Band Wiring of Olecranon Fractures

Abstract

Purpose: To evaluate the outcome following internal fixation of olecranon fractures using the techniques of tension band wiring and plating. Design: retrospective evaluation. Setting: regional trauma center. Patients and Methods: 48 consecutive patients with fractures of the olecranon were treated over a 20-month period (May 1993 to December 1994. Analyses of the results were based on the medical records, preand postoperative radiographs of all 48 patients and clinical review of 39 patients at a mean follow-up of > 2 years (range 28-48 months). Intervention: 25 fractures were fixed using the AO tension band-wiring technique and 23 were fixed with a plate; the selection of method was based on agreed radiologic fracturepattern criteria. Main outcome measurements: radiographic evaluation of the quality of reduction was carried out using a grading system. Clinical outcome was assessed using the Broberg & Morrey functional rating index. Results: Clinical evaluation of 39 patients was carried out. In the tension band-wiring group, 17 (85%) patients had an excellent or good outcome and eleven (55%) patients underwent a second procedure for symptomatic metalwork. In the plating group, 16 (84%) patients had an excellent or good outcome and two (11%) patients underwent a second procedure for symptomatic metalwork. The latter group had more complex and associated fractures and included the only poor result. Conclusion: Internal fixation of fractures of the olecranon results in good functional outcome. Patients who have tension band wiring more often require a second procedure for removal of symptomatic metalwork.

Tension plate for treatment of olecranon fractures: new surgical technique and case series study

“…We assessed the function of the extremity by measuring the range of flexion, extension, pronation and supination of the forearm, and we compared these values with those for the uninjured extremity of the same patient and with the reference values in literature to assess the success of the operative method and of the implant applied. [16][17][18] Approximately 6 months after the surgery, the patients were interviewed about their general impression and their possible difficulties (hardships present or not); in the presence of hardships we tried to assess them quantitatively (mild, moderate, intense). For this investigation we used the Mayo elbow performance score questionnaire, which takes into consideration objective (range of motion, stability of the joint) as well as subjective (existence and intensity of pain, daily functions of the joint) parameters for the appraisal of joint function.…”