Mini fragment plating provides a middle ground between tension band wiring and conventional olecranon plating in the management of comminuted olecranon fractures: A case series

Abstract

BackgroundThe management of comminuted olecranon fractures has plenty of room for improvement. There remains controversy for the ideal treatment modality, with tension band wiring (TBW) and locked plate fixation (LPF) being the most commonly utilised options. However, TBW and LPF have their own benefits and drawbacks. We explore a novel treatment strategy for comminuted olecranon fractures, utilising TBW in conjunction with mini-fragment plate (MFP) fixation. Case detailsWe treated five cases of Mayo Type IIB olecranon fractures with this method. All five patients were found to have union of the fracture. All patients were found to have good or excellent functional outcome. Only one patient complained of hardware prominence. None of the patients were found to have infection, wound complications, nor underwent revision surgery. The radiological outcome in terms of fracture union time and functional outcome in terms of Mayo Elbow Performance Index and Quick Disabilities of Arm Shoulder and Hand Score were comparable to reported outcomes of LPF in similar cases. ConclusionWe therefore propose the use of mini-fragment plates in conjunction with TBW to combine the advantages of TBW and plating, while limiting the drawbacks of traditional locked plate fixation.