Long-term results of olecranon fractures treated with tension-band wiring technique

Abstract

We evaluated the long-term results of olecranon fractures treated with tension-band wiring (Zuggurtung) technique. The study included 41 patients (28 males, 13 females; mean age 48 years; range 20 to 85 years) who underwent tension-band wiring osteosynthesis for olecranon fractures. The involved side was the right in 25 patients, and the left in 16 patients. Associated bone and soft-tissue injuries were detected in 16 patients. There were open fractures of Gustilo type 1 in two patients, and type 2 in one patient. The fractures were classified according to the Schatzker's system, and the results according to the Murphy's system. The mean follow-up was 46.7 months (range 12 to 141 months). Complete union was obtained in all fractures. According to the Murphy's system, the results were very good and good in 31 patients (75.6%), fair in five patients (12.2%), and poor in five patients (12.2%). It was obvious that fracture type and accompanying trauma had influenced the treatment results. Of open fractures, the results were poor in two patients, and fair in one patient. Of 10 patients with a fair or poor outcome, eight patients had accompanying bone injuries. Complications included migration of the K-wire in two patients, and irritation related to K-wires in four patients. Osteosynthesis with tension-band wiring technique in olecranon fractures offers considerable advantages: a stable fixation is obtained at a very low cost, development of joint stiffness is avoided by early elbow range of motion, and minimal joint stiffness seen in the long term does not present as a functional disability.