Tension Band Wiring of Olecranon Fractures

Abstract

Background

Tension band wiring of olecranon fractures has been shown to be associated with a high rate of metalwork removal. The purpose of this study was to investigate whether this remained true or whether there had been a reduction in metalwork removal following improvements in surgical technique.

Methods

The outcome of 44 olecranon fractures treated by tension band wire fixation were reviewed. Eighteen (41%) required a second operation to remove the metalwork. In order to determine what factors might pre-dispose to metalwork removal continuous (age) and categorical variables (sex, k-wire diameter, k-wire alignment, k-wire orientation, k-wire length distal to the fracture and the number of tightening loops on the cerclage wire) were evaluated.

Results

No statistical significance was identified when each variable was analysed individually or cumulatively using a multiple backward stepwise logistic regression (P<0.05). Using Kaplan-Meier survivorship analysis removal of the tension band device was found to be most commonly performed within 6 months of the index procedure.

Conclusion

This study indicates that metalwork removal is more importantly related to anatomical site rather than the specific surgical technique.