Outcome after olecranon fracture repair: Does construct type matter?

Area of Science:

• Orthopedic surgery
• Traumatology
• Skeletal reconstruction

Background:

• Displaced olecranon fractures are common injuries requiring surgical intervention.
• Treatment options include tension band wiring (TBW) and plate fixation (PF).
• Comparative outcome data between TBW and modern hook plate constructs are limited.

Purpose of the Study:

• To compare clinical and functional outcomes of displaced olecranon fractures treated with TBW versus hook plate fixation (PF).

Main Methods:

• Retrospective review of 48 patients with operatively treated olecranon fractures over 7 years.
• Patients were divided into TBW (n=23) and hook plate PF (n=25) groups.
• Outcomes assessed: range of motion, time to union, complications, and Mayo Elbow Performance Index (MEPI) scores.

Main Results:

• No significant differences in patient demographics, fracture type, or follow-up duration.
• Hook plate PF group showed significantly less terminal extension (-8.6° vs. -3.5°, p=0.036) and longer time to union (19 vs. 12 weeks, p=0.001).
• No differences in MEPI scores or other clinical outcomes; two patients in each group required revision surgery.

Conclusions:

• Both TBW and hook plate PF achieve excellent functional outcomes for olecranon fractures.
• TBW demonstrated faster union and superior elbow extension in this cohort.
• TBW remains a viable and effective treatment for select olecranon fractures.