Abstract
Purpose: Tension band wiring is the most common surgical procedure for fixation of fractures of the Olecranon, but it is associated with high rate of metal work complications and implant failure leading to re-operation.
Method: We present a new fixation technique for olecranon fractures that avoids reoperation to remove hardware as compared with the standard fixation technique with Kirschner wires and tension band wiring as advocated by the AO technique. We describe fixation of displaced transverse and oblique olecranon fractures with anchor sutures, each of which has two pairs of suture strands. Prior to the insertion of the anchor sutures, the fracture is reduced through a standard open approach
Results: Twelve patients have been treated with this technique so far, with a mean follow-up of 6 months. The mean age of the patients was 46.7 years (range 14–75 yrs). We have followed all these patients till union of the fractures. No immediate complications have been noted. Radiographic results are good, with no loss of reduction.
Conclusion: This technique avoids the need for reop-eration for hardware removal without compromising the quality of reduction. It may be argued that anchor sutures may cost more than tension band wiring which is a very low cost procedure. At the same time, we should also consider the future cost involved because of reoperation rate and morbidity. Our newly described technique would be particularly useful in dealing with olecranon fractures in children where it is undesirable to cross the physeal plate by metal work. It would also be of great value in dealing with intra articular distal humeral fractures where fixation is planned initially but conversion to total elbow replacement becomes essential intra-operatively. In such cases an olecranon osteotomy can be fixed by this technique, even in presence of a total elbow replacement.
The abstracts were prepared by Mr Matt Costa and Mr Ben Ollivere. Correspondence should be addressed to Mr Costa at Clinical Sciences Research Institute, University of Warwick, Clifford Bridge Road, Coventry CV2 2DX, UK.
