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Published in: European Journal of Orthopaedic Surgery & Traumatology 2/2020

01-02-2020 | Olecranon Fracture | Original Article • ELBOW - FRACTURES

Surgical technique in tension band wiring method for selected comminuted olecranon fractures

Authors: Michio Okamoto, Jiro Namba, Kohji Kuriyama, Satoshi Miyamura, Hiroyuki Yokoi, Koji Yamamoto

Published in: European Journal of Orthopaedic Surgery & Traumatology | Issue 2/2020

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Abstract

Background

The use of tension band wiring (TBW) for comminuted olecranon fractures is less recommendable these days. However, some experts preferentially apply TBW to comminuted fractures resulting in favorable outcomes. We here present the surgical technique using TBW with eyelet and absorbable pins for selected comminuted olecranon fractures and review the clinical and radiographic outcomes.

Methods

Twenty-four surgically treated patients with Colton Group 2C or 2D olecranon fractures in focus on the intermediate fragment (IMF) were enrolled. IMFs were primarily fixed with buried bioabsorbable poly-l-lactic acid pins followed by definitive fixation of the olecranon process with TBW with eyelet. The adequacy of the reconstructed notch was especially estimated by parameters on radiographs using digital imaging software.

Results

The average follow-up was 30 months (10 to 86 months). All 24 fractures achieved union, and the maintenance of the articular curvature was confirmed according to statistical analysis on radiographs. The average elbow flexion was 135.1° (range 100° to 145°), and the average elbow extension was − 4.8° (range − 20° to 10°). The mean Mayo Elbow Performance score was 97.3 points (range 80 to 100 points). No cases of pin migration, infection, nerve problem, heterotrophic ossification, or secondary osteoarthritis were observed.

Conclusions

For selected comminuted olecranon fractures, TBW with the eyelet pins and biodegradable pins could yield satisfactory clinical and radiographic outcomes.
Literature
1.
go back to reference Veillette CJ, Steinmann SP (2008) Olecranon fractures. Orthop Clin N Am 39:229–236CrossRef Veillette CJ, Steinmann SP (2008) Olecranon fractures. Orthop Clin N Am 39:229–236CrossRef
2.
go back to reference Siebenlist S, Torsiglieri T, Kraus T, Burghardt RD, Stöckle U, Lucke M (2010) Comminuted fractures of the proximal ulna—preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury 41:1306–1311CrossRef Siebenlist S, Torsiglieri T, Kraus T, Burghardt RD, Stöckle U, Lucke M (2010) Comminuted fractures of the proximal ulna—preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury 41:1306–1311CrossRef
3.
go back to reference Niglis L, Bonnomet F, Schenck B, Brinkert D, Di Marco A, Adam P, Ehlinger M (2015) Critical analysis of olecranon fracture management by pre-contoured locking plates. Orthop Traumatol Surg Res 101(2):201–207CrossRef Niglis L, Bonnomet F, Schenck B, Brinkert D, Di Marco A, Adam P, Ehlinger M (2015) Critical analysis of olecranon fracture management by pre-contoured locking plates. Orthop Traumatol Surg Res 101(2):201–207CrossRef
4.
go back to reference Erturer RE, Sever C, Sonmez MM, Ozcelik IB, Akman S, Ozturk I (2011) Results of open reduction and plate osteosynthesis in comminuted fracture of the olecranon. J Shoulder Elbow Surg 20(3):449–454CrossRef Erturer RE, Sever C, Sonmez MM, Ozcelik IB, Akman S, Ozturk I (2011) Results of open reduction and plate osteosynthesis in comminuted fracture of the olecranon. J Shoulder Elbow Surg 20(3):449–454CrossRef
5.
go back to reference DelSole EM, Pean CA, Tejwani NC, Egol KA (2016) Outcome after olecranon fracture repair: does construct type matter? Eur J Orthop Surg Traumatol 26(2):153–159CrossRef DelSole EM, Pean CA, Tejwani NC, Egol KA (2016) Outcome after olecranon fracture repair: does construct type matter? Eur J Orthop Surg Traumatol 26(2):153–159CrossRef
6.
go back to reference Amini MH, Azar FM, Wilson BR, Smith RA, Mauck BM, Throckmorton TW (2015) Comparison of outcomes and costs of tension-band and locking-plate osteosynthesis in transverse olecranon fractures: a matched-cohort study. Am J Orthop (Belle Mead NJ) 44(7):E211–E215 Amini MH, Azar FM, Wilson BR, Smith RA, Mauck BM, Throckmorton TW (2015) Comparison of outcomes and costs of tension-band and locking-plate osteosynthesis in transverse olecranon fractures: a matched-cohort study. Am J Orthop (Belle Mead NJ) 44(7):E211–E215
7.
go back to reference Matar HE, Ali AA, Buckley S, Garlick NI, Atkinson HD (2014) Surgical interventions for treating fractures of the olecranon in adults. Cochrane Database Syst Rev 80(1):106–111 Matar HE, Ali AA, Buckley S, Garlick NI, Atkinson HD (2014) Surgical interventions for treating fractures of the olecranon in adults. Cochrane Database Syst Rev 80(1):106–111
8.
go back to reference Kim JY, Lee YH, Gong HS, Lee SL, Lee SK, Baek GH (2013) Use of Kirschner wires with eyelets for tension band wiring of olecranon fractures. J Hand Surg Am 38(9):1762–1767CrossRef Kim JY, Lee YH, Gong HS, Lee SL, Lee SK, Baek GH (2013) Use of Kirschner wires with eyelets for tension band wiring of olecranon fractures. J Hand Surg Am 38(9):1762–1767CrossRef
9.
go back to reference Takada N, Kato K, Fukuta M, Wada I, Otsuka T (2013) Minimally invasive tension band wiring technique for olecranon fractures. Tech Hand Up Extrem Surg 17(4):199–201CrossRef Takada N, Kato K, Fukuta M, Wada I, Otsuka T (2013) Minimally invasive tension band wiring technique for olecranon fractures. Tech Hand Up Extrem Surg 17(4):199–201CrossRef
10.
go back to reference von Rüden C, Woltmann A, Hierholzer C, Trentz O, Bühren V (2011) The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures. J Orthop Surg Res 6:9CrossRef von Rüden C, Woltmann A, Hierholzer C, Trentz O, Bühren V (2011) The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures. J Orthop Surg Res 6:9CrossRef
11.
go back to reference Suresh SS (2009) Management of comminuted olecranon fractures with precut K-wires and tension band wiring. Tech Hand Up Extrem Surg 13:82–84CrossRef Suresh SS (2009) Management of comminuted olecranon fractures with precut K-wires and tension band wiring. Tech Hand Up Extrem Surg 13:82–84CrossRef
12.
go back to reference Colton CL (1973) Fractures of the olecranon in adults: classification and management. Injury 5:121–129CrossRef Colton CL (1973) Fractures of the olecranon in adults: classification and management. Injury 5:121–129CrossRef
13.
go back to reference Cabanela ME, Morrey BF (1993) Fractures of the proximal ulna and olecranon. In: Morrey BF (ed) The elbow and its disorders. WB Saunders, Philadelphia, pp 407–408 Cabanela ME, Morrey BF (1993) Fractures of the proximal ulna and olecranon. In: Morrey BF (ed) The elbow and its disorders. WB Saunders, Philadelphia, pp 407–408
14.
go back to reference Benetton CA, Cesa G, El-Kouba Junior G, Ferreira AP, Vissoci JR, Pietrobon R (2015) Agreement of olecranon fractures before and after the exposure to four classification systems. J Shoulder Elbow Surg 24(3):358–363CrossRef Benetton CA, Cesa G, El-Kouba Junior G, Ferreira AP, Vissoci JR, Pietrobon R (2015) Agreement of olecranon fractures before and after the exposure to four classification systems. J Shoulder Elbow Surg 24(3):358–363CrossRef
15.
go back to reference Kamiya T, Mikami T, Tasase K (2005) Outcome of the comminuted olecranon fractures. J Jpn Soc Surg Elbow 12:123–124 (article in Japanese) Kamiya T, Mikami T, Tasase K (2005) Outcome of the comminuted olecranon fractures. J Jpn Soc Surg Elbow 12:123–124 (article in Japanese)
16.
go back to reference Schliemann B, Raschke MJ, Groene P, Weimann A, Wähnert D, Lenschow S (2014) Comparison of tension band wiring and precontoured locking compression plate fixation in Mayo type IIA olecranon fractures. Acta Orthop Bel 80:106–111 Schliemann B, Raschke MJ, Groene P, Weimann A, Wähnert D, Lenschow S (2014) Comparison of tension band wiring and precontoured locking compression plate fixation in Mayo type IIA olecranon fractures. Acta Orthop Bel 80:106–111
17.
go back to reference Tarallo L, Mugnai R, Adani R, Capra F, Zambianchi F, Catani F (2014) Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques. Arch Orthop Trauma Surg 134(8):1107–1114CrossRef Tarallo L, Mugnai R, Adani R, Capra F, Zambianchi F, Catani F (2014) Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques. Arch Orthop Trauma Surg 134(8):1107–1114CrossRef
18.
go back to reference Ren YM, Qiao HY, Wei ZJ, Lin W, Fan BY, Liu J, Li A, Kang Y, Liu S, Hao Y, Zhou XH, Feng SQ (2016) Efficacy and safety of tension band wiring versus plate fixation in olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res 11(1):137CrossRef Ren YM, Qiao HY, Wei ZJ, Lin W, Fan BY, Liu J, Li A, Kang Y, Liu S, Hao Y, Zhou XH, Feng SQ (2016) Efficacy and safety of tension band wiring versus plate fixation in olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res 11(1):137CrossRef
19.
go back to reference Matsusue Y, Nakamura T, Iida H, Shimizu K (1997) A long-term clinical study on drawn poly-l-lactide implants in orthopaedic surgery. J Long Term Eff Med Implants 7:119–137PubMed Matsusue Y, Nakamura T, Iida H, Shimizu K (1997) A long-term clinical study on drawn poly-l-lactide implants in orthopaedic surgery. J Long Term Eff Med Implants 7:119–137PubMed
20.
go back to reference Matsusue Y, Yamamuro T, Oka M, Shikinami Y, Hyon SH, Ikada Y (1992) In vitro and in vivo studies on bioabsorbable ultra-high-strength poly(l-lactide) rods. J Biomed Mater Res 26:1553–1567CrossRef Matsusue Y, Yamamuro T, Oka M, Shikinami Y, Hyon SH, Ikada Y (1992) In vitro and in vivo studies on bioabsorbable ultra-high-strength poly(l-lactide) rods. J Biomed Mater Res 26:1553–1567CrossRef
21.
go back to reference Helm RH, Hornby R, Miller SW (1987) The complications of surgical treatment of displaced fractures of the olecranon. Injury 18:48–50CrossRef Helm RH, Hornby R, Miller SW (1987) The complications of surgical treatment of displaced fractures of the olecranon. Injury 18:48–50CrossRef
Metadata
Title
Surgical technique in tension band wiring method for selected comminuted olecranon fractures
Authors
Michio Okamoto
Jiro Namba
Kohji Kuriyama
Satoshi Miyamura
Hiroyuki Yokoi
Koji Yamamoto
Publication date
01-02-2020
Publisher
Springer Paris
Published in
European Journal of Orthopaedic Surgery & Traumatology / Issue 2/2020
Print ISSN: 1633-8065
Electronic ISSN: 1432-1068
DOI
https://doi.org/10.1007/s00590-019-02551-y

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