Plate Versus Tension-Band Wire Fixation for Olecranon Fractures: A Prospective Randomized Trial.

Area of Science:

• Orthopedic Surgery
• Trauma Surgery

Background:

• Simple isolated, displaced olecranon fractures require effective surgical fixation.
• Comparing tension-band wire (TBW) and plate fixation is crucial for optimal patient outcomes.

Purpose of the Study:

• To compare the one-year outcomes of TBW versus plate fixation for simple isolated, displaced olecranon fractures.

Main Methods:

• A prospective randomized trial included 67 patients (age 16-75) with displaced olecranon fractures.
• Patients were randomized to TBW (n=34) or plate fixation (n=33).
• Outcomes were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) score at one year.

Main Results:

• No significant difference in DASH scores at one year between TBW (12.8) and plate fixation (8.5) (p=0.315).
• Complication rates were higher with TBW fixation (63%) versus plate fixation (38%) (p=0.042), mainly due to symptomatic implant removal.
• Infections and revision surgeries occurred exclusively in the plate fixation group.

Conclusions:

• Both TBW and plate fixation provide comparable patient-reported outcomes for olecranon fractures at one year.
• TBW fixation is associated with a higher rate of symptomatic implant removal.
• Plate fixation carried a higher risk of serious complications like infection and revision surgery in this cohort.