Tension band wiring for simple olecranon fractures: evaluation of surgical technique

Abstract

BackgroundIn some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes.Materials and methodsForty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman’s rank correlation test.ResultsNone of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found.ConclusionsA rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment.Level of evidenceLevel IV diagnostic study.

New fixation approach for transverse metacarpal neck fracture: a biomechanical study

“…The approach of integrating a figure-of-eight cerclage wire to two K-wires and adopted in the present study was inspired by the use of tension band wiring (TBW) fixation [ 34 ] in a previous study to treat patella transverse fracture. TBW is widely employed to treat limb fractures, including distal clavicle fracture [ 35 ], olecranon fracture [ 36 ], and medial malleolar fracture [ 37 ]. The advantages of TBW are (1) higher antirotation force [ 3 ] compared with that in K-wire fixation, (2) higher antibending force compared with that in wire fixation, and (3) lower profile compared with the bone plate, which reduces tendon irritation.…”

Displaced olecranon fractures in the elderly: outcomes after non-operative treatment – a narrative review

“…Therefore, patient age of over 75 years old was regarded as an exclusion criteria for operative treatment in their studies. 33 , 42 …”

Correction to: Tension band wiring for simple olecranon fractures: evaluation of surgical technique

“…Unfortunately, after publication of this article [ 1 ], it was noticed that the author J. Carel Goslings was tagged incorrectly during the production process. This resulted in the PubMed display of the author name as ‘J Carel Goslings’.…”