Biomechanical comparison of continuous compression implants versus tension band fixation for transverse olecranon fractures

Abstract

PurposeTension band wiring (TBW) is considered the ‘gold standard’ for fixation of transverse olecranon fractures (OTA/AO 2U1B1d). However, this approach requires a large exposure, can be technically demanding and operator-dependent, and is associated with hardware prominence. Continuous compression implants (CCI) may address these limitations. To the authors' knowledge, a comparison between TBW and CCI has not been performed. Therefore, this study was designed to compare biomechanical properties of CCI to TBW for 2U1B1d olecranon fractures using human cadaver elbows. MethodsA transverse olecranon fracture was simulated in eight matched pairs of cadaveric elbows. Matched pairs were used for comparison of TBW and CCI. Cyclic loading was performed at both 10 N and 500 N, with gap formation and load to failure recorded. Results: No significant difference in gap formation at 10 N (p > 0.3) or 500 N (p = 0.6), or load-to-failure (p=.00.41), was observed between the two groups. DiscussionCCI fixation requires a smaller incision, is easy to perform, and involves low-profile implant that may reduce morbidity. Based on biomechanical properties that match the gold standard, continuous compression nitinol implants are an appropriate option for fixation of transverse olecranon fractures with potential advantages over tension band wiring.