Outcome after olecranon fracture repair: Does construct type matter?
PURPOSE
This study compares clinical and functional outcomes of patients with displaced olecranon fractures treated with either tension band wiring (TBW) or a hook plate construct.


METHODS
We performed a retrospective review of olecranon fractures operatively treated with either TBW or plate fixation (PF) using a hook plate over a 7-year period. Patient demographics, injury information, and surgical management were recorded. Fractures were classified according to the Mayo system. Measured outcomes included range of elbow motion, time to union, and development of postoperative complications. Mayo Elbow Performance Index (MEPI) scores were obtained for all patients. All patients were followed for a minimum of 6 months.


RESULTS
A total of 48 patients were included in this study, 23 treated with TBW and 25 treated with hook PF. Groups did not differ with respect to patient demographics, Mayo fracture type, or duration of follow-up. Patients undergoing PF had less terminal extension than TBW patients (-8.6° ± 7° vs. -3.5° ± 9.3°, p = 0.036) and a longer time to radiographic union (19 ± 8 vs. 12 ± 6 weeks, p = 0.001). There were no differences in rates of symptomatic hardware, MEPI scores, or other clinical outcomes. Two patients in each group required a second surgery.


CONCLUSIONS
TBW and PF of olecranon fractures had similarly excellent functional outcomes in this study. Patients undergoing PF had a longer time to union and slightly worse extension at final follow-up. TBW remains an effective treatment for appropriately selected olecranon fractures and in this cohort outperformed plate osteosynthesis.
['DelSole|Edward M|EM|', 'Pean|Christian A|CA|http://orcid.org/0000-0001-7445-1152', 'Tejwani|Nirmal C|NC|', 'Egol|Kenneth A|KA|']
D000368:Aged D001860:Bone Plates D001864:Bone Wires D005260:Female D005593:Fracture Fixation, Internal D006801:Humans D008297:Male D008875:Middle Aged D056740:Olecranon Process D016059:Range of Motion, Articular D012189:Retrospective Studies D016896:Treatment Outcome D014458:Ulna Fractures
Olecranon fracture Tension band wiring Hook plate Clinical outcomes Olecranon fixation