Tension Band Wiring Provides Excellent Patient-Reported Long-Term Results for Both Comminuted and Simple Displaced Olecranon Fractures

OBJECTIVES: To assess the long-term functional results of both simple and comminuted olecranon fractures treated with tension band wiring (TBW).

DESIGN: Retrospective.

SETTING: Level 1 trauma center.

PATIENTS & INTERVENTION: Between 2004 and 2014, 178 fractures in 178 patients >16 years of age were treated with TBW for a unilateral olecranon fracture.

MAIN OUTCOME MEASUREMENTS: Subjective functionality was tested with the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire and the Mayo Elbow Performance Index (MEPI).

RESULTS: Fifty percent of our cohort were lost to follow-up leaving 89 for review. A total of 51.7% had a comminuted fracture. Mean follow-up time was 7.1 years. Reoperation rate for implant removal was 84%. The total median DASH score was 0.83. Eighty-five patients (95.5%) were rated excellent using the MEPI score. No significant difference in either score was found between the simple (SF) and the comminuted (CF) group. Median range of motion was flexion/extension: 145/-2 degrees, supination/pronation: 90/90 degrees. No clinically relevant difference in range of motion was found between the 2 groups.

CONCLUSIONS: We found no relevant differences in either subjective or objective functionality between patients with simple or comminuted olecranon fractures after fixation with TBW. Therefore, TBW seems to be an adequate and justifiable treatment modality for both simple and comminuted olecranon fractures.

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.