Use of Tension Band Wiring Technique in Proximal Ulnar Fractures: A Finite Element Biomechanical Analysis

Abstract

Background: Tension band wiring is considered the standard treatment for olecranon fracture. A recentstudy proved that it can be used for the fracture as distal to the coronoid process.
 Objective: The study aimed to investigate whether tension band wiring can be used in proximal ulnarfracture fixation up to and distal to the coronoid process.
 Methods: Models of simple proximal ulnar fracture including 4 intraarticular and 2 extraarticularfractures were created. Fixation was completed using tension band wiring technique, and biomechanicalresponses were evaluated using finite element analysis. After a physiologic load was applied, thefracture displacement, von Mises stress, and stiffness were recorded.
 Results: All fracture models were able to withstand the load of daily activities with a maximumdisplacement of 50% of the articular surface. In addition, the von Mises stress was the highest in themiddle articular fracture. The mean transcortical K-wire tension band wiring stiffness of the intraarticular and extra-articular fractures was 1144.89 N/mm and 1231.45 N/mm, respectively.
 Conclusion: Tension band wiring is another option to treat proximal ulnar fractures with the ability towithstand immediate postoperative load.