Plate fixation and tension band wiring after isolated olecranon fracture comparison of outcome and complications

Gathen, Martin; Jaenisch, Max; Peez, Christian; Weinhold, Leonie; Schmid, Matthias; Welle, Kristian; Burger, C.; Kabir, Koroush

doi:10.1016/j.jor.2019.09.017

Cited by 22 publications

(21 citation statements)

References 36 publications

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“…There was no difference in functional effects between Group TBW and Group PF (in terms of the MEPS, forearm arc, elbow exion, and RTW), which was consistent with previous studies [4,[9][10][11][12][13]. Multivariate analysis demonstrated that the only independent factor that affected the MEPS was fracture type (69.7% vs 30.3%, P = 0.03), indicating that the severity of the olecranon fracture was negatively correlated with the treatment e cacy of olecranon fracture.…”

Section: Discussionsupporting

confidence: 91%

More Metalwork Removals of Olecranon Fractures After Tension Banding Wiring than Plate Fixation-A Propensity Score Matching Analysis

Qiu

et al. 2021

Preprint

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Background: Traditional tension band wiring and plate fixation represent the most common methods for treating olecranon fractures. However, there is no agreement as to which method provides the best outcome. The aim of this retrospective study was to compare the outcomes of tension band wiring (TBW) and plate fixation (PF) for treating displaced olecranon fractures. This is the first study to use propensity score matching analysis to compare treatment methods for olecranon fracture.Method: A total of 107 patients aged between 18 and 85 years old had acute isolated and displaced olecranon fractures. The patients were divided into either TBW (n=49) or PF (n=58) groups. To conduct propensity score matching for the treatment method (TBW versus PF), 58 patients were analyzed by logistic regression (29 patients in each group). Various demographic and treatment-related variables were examined and analyzed to determine their correlation. Results: Functional effects between two groups are similar( in terms of Mayo Elbow Performance Score (MEPS), the patients’ range of elbow motion (ROM) and forearm rotation (RFR), the time return to work (RTW)). The total adverse events rate and metalwork removal events rate are higher in TBW than that in PF. After propensity score matching analysis, the similar primary treatment efficacy (indicated by excellent MEPS) and higher primary adverse events rate ( indicated by metalwork removal) were perceived in TBW than that in PF. Logistic regression analysis revealed that fracture type was an independent factor that affected the efficacy of a treatment (regression coefficient=-1.24<0, P=0.03), indicating that fracture severity was inversely proportional to the efficacy of a treatment for olecranon fracture. Furthermore, logistic regression analysis demonstrated that the treatment method was an independent factor that affected metalwork removal of olecranon fracture (regression coefficient 2.38 > 0, OR = 10.77, P < 0.01), indicating that the risk of metalwork removal in the TBW Group was 10.77 times that in the PF Group.Conclusion: The results indicated that plate fixation should be the first choice of treatment method for olecranon fractures, especially in younger patients with higher quality of life requirements.Trial regislation: The study was not registered in the clinical trial registration center, because it was a retrospective case-control study, which was an observational study with no intervention measures.Level of evidence: Level III; Retrospective Cohort Comparison; Treatment Study

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Section: Discussionsupporting

confidence: 91%

More Metalwork Removals of Olecranon Fractures After Tension Banding Wiring than Plate Fixation-A Propensity Score Matching Analysis

Qiu

et al. 2021

Preprint

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“…The DASH and Mayo scores are the most preferred and most reliable ones, and they have an important place in the evaluation of olecranon fractures following operation. In a study conducted by Gathen et al,[ 5 ] the DASH and Mayo scores were applied to compare the TBW and PF procedures in cases of olecranon fractures and no significant difference was found between the two procedures. Furthermore, in a systematic review and meta-analysis conducted by Ren et al,[ 27 ] no significant difference was found between TBW and PF procedures in terms of DASH score, improvement rate, joint ROM, operation time, and blood loss.…”

Section: Discussionmentioning

confidence: 99%

“…One advantage of the PF procedure is that it provides more stable fixation than TBW in cases of complex fractures. [ 5 ] In this procedure, after the fracture line is revealed, temporary fracture reduction is also provided with a bone clamp. Then, a 3.5-mm limited contact dynamic compression plate suitable for olecranon and proximal ulna anatomy is placed and fixation is completed with locking screws (Figure 5a, b).…”

Section: Methodsmentioning

confidence: 99%

“…Tension band wiring is a simple and low-cost procedure and so it is considered the gold standard by many authors. [ 5 ] Functional results are satisfactory in the treatment of simple olecranon fractures, but there are limited indications in comminuted fractures. [ 6 ] In addition, high complication rates and secondary surgical requirements have been reported in some studies.…”

Section: Introductionmentioning

confidence: 99%

“…Tension band wiring is a simple and low-cost procedure and so it is considered the gold standard by many authors. [5] Functional results are satisfactory in the 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.…”

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

et al. 2021

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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.

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Implants for Olecranon and Coronoid Fractures

Dirckx,

Jukes,

Phadnis

2022

Handbook of Orthopaedic Trauma Implantology

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Plate fixation and tension band wiring after isolated olecranon fracture comparison of outcome and complications

Cited by 22 publications

References 36 publications

More Metalwork Removals of Olecranon Fractures After Tension Banding Wiring than Plate Fixation-A Propensity Score Matching Analysis

More Metalwork Removals of Olecranon Fractures After Tension Banding Wiring than Plate Fixation-A Propensity Score Matching Analysis

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

Implants for Olecranon and Coronoid Fractures

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