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Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study

Year 2015, Volume: 49 Issue: 6, 654 - , 28.10.2015

Abstract

Objective: The aim of this study was to assess the therapeutic effects and complications of tension band wiring (TBW) through the use of double-cannulated screws versus conventional TBW in the treatment of olecranon fractures.
Methods: Eligible participants were randomly assigned to 2 groups to undergo different methods of fixation. The related indices and data of the 2 groups were collected for comparative analysis after an average follow-up of 32.7±6.6 months.
Results: Average fracture healing time was 11.4 weeks in the double-screw TBW group and 12.6±1.8 weeks in the conventional TBW group (p=0.000). There was significant difference in complications related to fixation between the 2 groups. In the double-screw TBW group (42 patients), 2 patients felt screw head prominence with no pain and requested no further intervention; in contrast, 21 patients experienced complications associated with internal fixation in the conventional TBW group. Mean Mayo Elbow Performance Score (MEPS) score was 87.90±6.0 in the double-screw TBW group, compared to 83.67±6.6 in the conventional TBW group at 24-month follow-up (p=0.002). The rate of elbow function in the double-screw TBW group (29/42, 69.05%) was higher than that of the conventional TBW group (16/46, 34.78%) (p=0.000).
Conclusion: In comparison with conventional TBW, TBW with double-cannulated screws can significantly reduce complications, lower reoperation rate, improve elbow function, shorten healing time, as well as diminish surgical trauma.
 

DOI: 10.3944/AOTT.2015.14.0330

References

  • Rommens PM, Küchle R, Schneider RU, Reuter M. Olec- ranon fractures in adults: factors influencing outcome. In- jury 2004;35:1149–57.
  • Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am 2008;39:229–36.
  • Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the “gold standard” for the treatment of olecranon fractures? A long term functional outcome study. J Orthop Surg Res 2008;3:9.
  • Mauffrey CP, Krikler S. Surgical techniques: how I do it? Open reduction and tension band wiring of olecranon fractures. Injury 2009;40:461–5.
  • Mullett JH, Shannon F, Noel J, Lawlor G, Lee TC, O’Rourke SK. K-wire position in tension band wiring of the olecranon - a comparison of two techniques. Injury 2000;31:427–31.
  • Murphy DF, Greene WB, Dameron TB Jr. Displaced olec- ranon fractures in adults. Clinical evaluation. Clin Orthop Relat Res 1987;224:215–23.
  • Parker JR, Conroy J, Campbell DA. Anterior interosseus nerve injury following tension band wiring of the olecra- non. Injury 2005;36:1252–3.
  • Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg Am 1985;67:1396–401.
  • Karlsson MK, Hasserius R, Karlsson C, Besjakov J, Josefsson PO. Fractures of the olecranon: a 15- to 25- year followup of 73 patients. Clin Orthop Relat Res 2002;403:205–12.
  • Villanueva P, Osorio F, Commessatti M, Sanchez-Sotelo J. Tension-band wiring for olecranon fractures: analy- sis of risk factors for failure. J Shoulder Elbow Surg 2006;15:351–6.
  • Morrey BF, An K-N: Functional evaluation of the elbow. In: The Elbow and Its Disorders, 3rd edn (Morrey BF, ed). Philadelphia: WB Saunders 2000. p. 74–83.
  • Schatzker J. Fractures of the olecranon. In: Schatzker J, Tile M,eds. The Rationale of Operative Fracture Care. New York, NY:Springer-Verlag 1996:113–9.
  • Akman S, Ertürer RE, Tezer M, Tekeşin M, Kuzgun U. Long-term results of olecranon fractures treated with tension-band wiring technique. [Article in Turkish] Acta Orthop Traumatol Turc 2002;36:401–7.
  • Hume MC, Wiss DA. Olecranon fractures. A clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop Relat Res 1992;285:229–35.
  • Karlsson MK, Hasserius R, Besjakov J, Karlsson C, Josefs- son PO. Comparison of tension-band and figure-of-eight wiring techniques for treatment of olecranon fractures. J Shoulder Elbow Surg 2002;11:377–82.
  • Romero JM, Miran A, Jensen CH. Complications and re-operation rate after tension-band wiring of olecranon fractures. J Orthop Sci 2000;5:318–20.
  • Wu CC, Tai CL, Shih CH. Biomechanical compari- son for different configurations of tension band wiring techniques in treating an olecranon fracture. J Trauma 2000;48:1063–7.
  • Prayson MJ, Williams JL, Marshall MP, Scilaris TA, Lin- genfelter EJ. Biomechanical comparison of fixation meth- ods in transverse olecranon fractures: a cadaveric study. J Orthop Trauma 1997;11:565–72.
  • Huang TW, Wu CC, Fan KF, Tseng IC, Lee PC, Chou YC. Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations. J Trauma 2010;68:173–6.
  • Johnson RP, Roetker A, Schwab JP. Olecranon fractures treated with AO screw and tension bands. Orthopedics 1986;9:66–8.
  • Jones TB, Karenz AR, Weinhold PS, Dahners LE. Trans- cortical screw fixation of the olecranon shows equivalent strength and improved stability compared with tension band fixation. J Orthop Trauma 2014;28:137–42.
  • Uhlmann M, Barg A, Valderrabano V, Weber O, Wirtz DC, Pagenstert G. Treatment of isolated fractures of the olecranon: percutaneous double-screw fixation versus conventional tension band wiring. [Article in German] Unfallchirurg 2014;117:614–23. [Abstract]
  • Hutchinson DT, Horwitz DS, Ha G, Thomas CW, Ba- chus KN. Cyclic loading of olecranon fracture fixation constructs. J Bone Joint Surg Am 2003;85–A:831–7.
  • Nork SE, Jones CB, Henley MB. Surgical treatment of olecranon fractures. Am J Orthop (Belle Mead NJ) 2001;30:577–86.
  • Wadsworth TG. Screw fixation of the olecranon after frac- ture or osteotomy. Clin Orthop Relat Res 1976;119:197– 201.
  • Candal-Couto JJ, Williams JR, Sanderson PL. Impaired forearm rotation after tension-band-wiring fixation of olecranon fractures: evaluation of the transcortical K-wire technique. J Orthop Trauma 2005;19:480–2.
  • Prayson MJ, Iossi MF, Buchalter D, Vogt M, Towers J. Safe zone for anterior cortical perforation of the ulna dur- ing tension-band wire fixation: a magnetic resonance im- aging analysis. J Shoulder Elbow Surg 2008;17:121–5.
Year 2015, Volume: 49 Issue: 6, 654 - , 28.10.2015

Abstract

References

  • Rommens PM, Küchle R, Schneider RU, Reuter M. Olec- ranon fractures in adults: factors influencing outcome. In- jury 2004;35:1149–57.
  • Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am 2008;39:229–36.
  • Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the “gold standard” for the treatment of olecranon fractures? A long term functional outcome study. J Orthop Surg Res 2008;3:9.
  • Mauffrey CP, Krikler S. Surgical techniques: how I do it? Open reduction and tension band wiring of olecranon fractures. Injury 2009;40:461–5.
  • Mullett JH, Shannon F, Noel J, Lawlor G, Lee TC, O’Rourke SK. K-wire position in tension band wiring of the olecranon - a comparison of two techniques. Injury 2000;31:427–31.
  • Murphy DF, Greene WB, Dameron TB Jr. Displaced olec- ranon fractures in adults. Clinical evaluation. Clin Orthop Relat Res 1987;224:215–23.
  • Parker JR, Conroy J, Campbell DA. Anterior interosseus nerve injury following tension band wiring of the olecra- non. Injury 2005;36:1252–3.
  • Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg Am 1985;67:1396–401.
  • Karlsson MK, Hasserius R, Karlsson C, Besjakov J, Josefsson PO. Fractures of the olecranon: a 15- to 25- year followup of 73 patients. Clin Orthop Relat Res 2002;403:205–12.
  • Villanueva P, Osorio F, Commessatti M, Sanchez-Sotelo J. Tension-band wiring for olecranon fractures: analy- sis of risk factors for failure. J Shoulder Elbow Surg 2006;15:351–6.
  • Morrey BF, An K-N: Functional evaluation of the elbow. In: The Elbow and Its Disorders, 3rd edn (Morrey BF, ed). Philadelphia: WB Saunders 2000. p. 74–83.
  • Schatzker J. Fractures of the olecranon. In: Schatzker J, Tile M,eds. The Rationale of Operative Fracture Care. New York, NY:Springer-Verlag 1996:113–9.
  • Akman S, Ertürer RE, Tezer M, Tekeşin M, Kuzgun U. Long-term results of olecranon fractures treated with tension-band wiring technique. [Article in Turkish] Acta Orthop Traumatol Turc 2002;36:401–7.
  • Hume MC, Wiss DA. Olecranon fractures. A clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop Relat Res 1992;285:229–35.
  • Karlsson MK, Hasserius R, Besjakov J, Karlsson C, Josefs- son PO. Comparison of tension-band and figure-of-eight wiring techniques for treatment of olecranon fractures. J Shoulder Elbow Surg 2002;11:377–82.
  • Romero JM, Miran A, Jensen CH. Complications and re-operation rate after tension-band wiring of olecranon fractures. J Orthop Sci 2000;5:318–20.
  • Wu CC, Tai CL, Shih CH. Biomechanical compari- son for different configurations of tension band wiring techniques in treating an olecranon fracture. J Trauma 2000;48:1063–7.
  • Prayson MJ, Williams JL, Marshall MP, Scilaris TA, Lin- genfelter EJ. Biomechanical comparison of fixation meth- ods in transverse olecranon fractures: a cadaveric study. J Orthop Trauma 1997;11:565–72.
  • Huang TW, Wu CC, Fan KF, Tseng IC, Lee PC, Chou YC. Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations. J Trauma 2010;68:173–6.
  • Johnson RP, Roetker A, Schwab JP. Olecranon fractures treated with AO screw and tension bands. Orthopedics 1986;9:66–8.
  • Jones TB, Karenz AR, Weinhold PS, Dahners LE. Trans- cortical screw fixation of the olecranon shows equivalent strength and improved stability compared with tension band fixation. J Orthop Trauma 2014;28:137–42.
  • Uhlmann M, Barg A, Valderrabano V, Weber O, Wirtz DC, Pagenstert G. Treatment of isolated fractures of the olecranon: percutaneous double-screw fixation versus conventional tension band wiring. [Article in German] Unfallchirurg 2014;117:614–23. [Abstract]
  • Hutchinson DT, Horwitz DS, Ha G, Thomas CW, Ba- chus KN. Cyclic loading of olecranon fracture fixation constructs. J Bone Joint Surg Am 2003;85–A:831–7.
  • Nork SE, Jones CB, Henley MB. Surgical treatment of olecranon fractures. Am J Orthop (Belle Mead NJ) 2001;30:577–86.
  • Wadsworth TG. Screw fixation of the olecranon after frac- ture or osteotomy. Clin Orthop Relat Res 1976;119:197– 201.
  • Candal-Couto JJ, Williams JR, Sanderson PL. Impaired forearm rotation after tension-band-wiring fixation of olecranon fractures: evaluation of the transcortical K-wire technique. J Orthop Trauma 2005;19:480–2.
  • Prayson MJ, Iossi MF, Buchalter D, Vogt M, Towers J. Safe zone for anterior cortical perforation of the ulna dur- ing tension-band wire fixation: a magnetic resonance im- aging analysis. J Shoulder Elbow Surg 2008;17:121–5.
There are 27 citations in total.

Details

Primary Language English
Journal Section Original Article
Authors

Qi-feng Lu This is me

Xi-jiang Zhao This is me

Gen-ling Tang This is me

Wen-jie Zhang This is me

Shu-guang Guo This is me

Hang-zhou Wang This is me

Publication Date October 28, 2015
Published in Issue Year 2015 Volume: 49 Issue: 6

Cite

APA Lu, Q.-f., Zhao, X.-j., Tang, G.-l., Zhang, W.-j., et al. (2015). Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthopaedica Et Traumatologica Turcica, 49(6), 654. https://doi.org/10.3944/AOTT.2015.14.0330
AMA Lu Qf, Zhao Xj, Tang Gl, Zhang Wj, Guo Sg, Wang Hz. Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthopaedica et Traumatologica Turcica. October 2015;49(6):654. doi:10.3944/AOTT.2015.14.0330
Chicago Lu, Qi-feng, Xi-jiang Zhao, Gen-ling Tang, Wen-jie Zhang, Shu-guang Guo, and Hang-zhou Wang. “Tension Band Wiring through Double-Cannulated Screws As a New Internal Fixation Method for Treatment of Olecranon Fractures: A Randomized Comparative Study”. Acta Orthopaedica Et Traumatologica Turcica 49, no. 6 (October 2015): 654. https://doi.org/10.3944/AOTT.2015.14.0330.
EndNote Lu Q-f, Zhao X-j, Tang G-l, Zhang W-j, Guo S-g, Wang H-z (October 1, 2015) Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthopaedica et Traumatologica Turcica 49 6 654.
IEEE Q.-f. Lu, X.-j. Zhao, G.-l. Tang, W.-j. Zhang, S.-g. Guo, and H.-z. Wang, “Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study”, Acta Orthopaedica et Traumatologica Turcica, vol. 49, no. 6, p. 654, 2015, doi: 10.3944/AOTT.2015.14.0330.
ISNAD Lu, Qi-feng et al. “Tension Band Wiring through Double-Cannulated Screws As a New Internal Fixation Method for Treatment of Olecranon Fractures: A Randomized Comparative Study”. Acta Orthopaedica et Traumatologica Turcica 49/6 (October 2015), 654. https://doi.org/10.3944/AOTT.2015.14.0330.
JAMA Lu Q-f, Zhao X-j, Tang G-l, Zhang W-j, Guo S-g, Wang H-z. Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthopaedica et Traumatologica Turcica. 2015;49:654.
MLA Lu, Qi-feng et al. “Tension Band Wiring through Double-Cannulated Screws As a New Internal Fixation Method for Treatment of Olecranon Fractures: A Randomized Comparative Study”. Acta Orthopaedica Et Traumatologica Turcica, vol. 49, no. 6, 2015, p. 654, doi:10.3944/AOTT.2015.14.0330.
Vancouver Lu Q-f, Zhao X-j, Tang G-l, Zhang W-j, Guo S-g, Wang H-z. Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study. Acta Orthopaedica et Traumatologica Turcica. 2015;49(6):654.