Clinical and radiographic outcome of tension band suture fixation for displaced olecranon fractures.

Publisher: BioMed Central Country of Publication: England NLM ID: 100968565 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2474 (Electronic) Linking ISSN: 14712474 NLM ISO Abbreviation: BMC Musculoskelet Disord Subsets: MEDLINE

Original Publication: London : BioMed Central, [2000-

Fracture Fixation, Internal*/methods ; Fracture Fixation, Internal*/instrumentation ; Olecranon Fracture*/diagnostic imaging ; Olecranon Fracture*/surgery ; Suture Techniques*; Adult ; Aged ; Female ; Humans ; Male ; Middle Aged ; Bone Wires ; Elbow Joint/surgery ; Elbow Joint/diagnostic imaging ; Follow-Up Studies ; Olecranon Process/injuries ; Olecranon Process/surgery ; Olecranon Process/diagnostic imaging ; Radiography ; Range of Motion, Articular ; Reoperation ; Retrospective Studies ; Treatment Outcome ; Young Adult

Background: Tension band wire fixation (TBW) is a well-described method for treating displaced olecranon fractures. Further surgery is often needed due to wound breakdown or prominent hardware. An all-suture technique has recently been described as an alternative to TBW but radiographic and clinical outcome are not well established. The aim of this single-center retrospective cohort study was to evaluate outcome after treatment with all-suture technique for simple displaced olecranon fractures.
Methods: A retrospective review of olecranon fractures in patients (> 18 years) treated for displaced olecranon fractures with tension band suture fixation (TBSF) between February and August 2019 was performed in our facility. Primary outcome was revision surgery, which was assessed four years after surgery. Clinical and radiographical follow-up was performed at two weeks, six weeks, three months and six months to assess union rate, fracture displacement, range of motion (ROM), Quick-DASH and Oxford Elbow Score.
Results: A total of 24 patients were included. Median age was 64 years [IQR:39-73], 9 patients were male and median ASA score was 2 [IQR:1-2]. 15 fractures were Mayo type 2 A and 9 type 2B with minor comminution. At four-year follow-up, three patients had died. None of the remaining 21 patients had undergone revision surgery. At six months, the median Quick-DASH and Oxford Elbow Score were 2.3 [IQR:0-4.5] and 47 [IQR:46-48], respectively. Median elbow extension and flexion deficits were 0° [IQR:0-2.25] and 0° [IQR:0-0], respectively. Radiographic union was achieved in all patients. In two cases radiographic loss of reduction and malunion was observed but both patients were asymptomatic and had no functional deficits. One patient refractured the elbow due to a second trauma and was reoperated.
Conclusions: TBSF is a promising technique for Mayo type 2 A and 2B fractures with minor comminution. There were no revision surgeries within the first four years. We found good functional outcomes and a high union rate.
(© 2024. The Author(s).)

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Keywords: Displaced fractures; Elbow; Fractures of the olecranon; Internal fixation; Management; Olecranon fractures; Suture; Tension band; Tension band wiring

Date Created: 20240821 Date Completed: 20240822 Latest Revision: 20240827

20240827

PMC11340050

10.1186/s12891-024-07788-1

39169336