DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20214037

Clinico-radiological and functional outcome of Mayo type IIA olecranon fractures managed with tension band wiring in a tertiary care centre in North India

Pankaj Spolia, Abdul Ghani, Sakib Arfee

Abstract


Background: Tension band wiring is the most common operative technique for the internal fixation of olecranon fractures. Stable internal fixation with figure of eight tension band wiring used for simple transverse fractures allows early range of motion, minimize stiffness and gives good results. The aim of this study is to evaluate the functional outcome of simple transverse fractures managed by tension band wiring.

Methods: This was an observational prospective study of 24 patients with Mayo type IIA fractures aged between 18 to 65 years, with mean age of 42.5 years treated by tension band wiring. Functional outcome was assessed with Mayo Elbow Performance Score (MEPS) and Visual Analogue Scale (VAS) subjective pain score.

Results: Our study was conducted on 24 patients with Mayo type IIA, out of which 16 were males and 8 were females. Most common mode of injury was fall from standing height (75%), followed by road traffic accident (16.7%) and assault (8.3%). The age range was between 18 to 65 years, with mean age of 42.5 years.

Conclusions: Tension band wiring is an effective method for the treatment of transverse, non-comminuted and unstable fractures of the olecranon which provides stable fixation, early rehabilitation and gives excellent results when done in expert hands.


Keywords


Tension band wiring, Mayo elbow performance score, Mayo classification

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References


Veillett CJH, Steinmann SP. Olecranon fractures. Orthop Clin North Am. 2008;39:229-36.

Duckworth AD, Court-Brown CM, McQueen MM. Isolated displaced olecranon fracture. J Hand Surg (Am) 2012;37A:341-5.

Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the ‘gold standard’ for the treatment of olecranon fractures? A long term functional outcome study. J Orthop Surg Res. 2008;3:9

Schneider MM, Nowak TE, Bastian L, Katthagen JC, Isenberg J, Rommens PM et al. Tension band wiring in olecranon fractures: the myth of technical simplicity and osteosynthetical perfection. Int Orthop. 2014;38:847-55.

Duckworth AD, Bugler KE, Clement ND. Nonoperative management of displaced olecranon fractures in low-demand elderly patients. J Bone Joint Surg Am. 2014;96(1):67-72.

Gallucci GL, Piuzzi NS, Slullitel PAI. Non-surgical functional treatment for displaced olecranon fractures in the elderly. Bone Joint J. 2014;96-B(4):530-34.

Kloen P, Buijze GA. Treatment of proximal ulna and olecranon fractures by dorsal plating. Oper Orthop Traumatol. 2009;21:571-85.

Helm RH, Miller SW. The complications of surgical treatment of displaced fractures of the olecranon. Injury. 1987;18(1):48-50.

Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg Am. 1985;67:1396-401.

Morrey BF, An KN, Chao EYS. Functional evaluation of the elbow. In: The Elbow and Its Disorders. 2nd edition. Edited by Morrey BF. Philadelphia: WB Saunders. 1993;86-9.

Jensen MP. Interpretation of visual analogue scale ratings and change scores. JPain. 2003;407-14.

Hak DJ, Stewart RL. Prinzip der Zuggurtung. In: AO-Prinzipien des Frakturmanagements. Auflage. Rüedi TP, Buckley RE, Moran CG (eds). Georg Thieme Verlag KG, Stuttgart. 2008;2:249-54.

Parker JR, Conroy J, Campbell DA. Anterior interosseus nerve injury following tension band wiring of the olecranon. Injury. 2005;36(10):1252.

Thumroj E, Jianmongkol S, Thammaroj J. Median nerve palsy after operative treatment of olecranon fracture. J Med Assoc Thai. 2005;88(10):1434-7.

Van der Linden SC, van Kampen A, Jaarsma RL. K-wire position in tension-band wiring technique affects stability of wires and long-term outcome in surgical treatment of olecranon fractures. Journal of shoulder and elbow surgery/American Shoulder and Elbow Surgeons. 2012;21:405-11.

Deliyannis SN. Comminuted fractures of the olecranon treated by the Weber-Vasey technique. Injury. 1973;5(1):19-24.

Mauffrey C, Krikler S. Surgical techniques: how I do it? Open reduction and tension band wiring of olecranon fractures. Injury. 2009;40(4):461-5.

Horner SR, Sadasivan KK, Lipka JM, Saha S. Analysis of mechanical factors affecting fixation of olecranon fractures. Orthopedics. 1989;12(11):1469-725.

Rommens PM, Kuchle R, Schneider RU, Reuter M. Olecranon fractures in adults: factors influencing outcome. Injury. 2004;35:1149-57.

Claessen FMAP, van den Bekerom MPJ, van Dijk CN, Goslings JC, Kerkhoffs GMMJ, Doornberg JN, et al. Shoulder elbow platform. Tension band wiring for simple olecranon fractures: evaluation of surgical technique. J Orthop Traumatol. 2017;18(3):275-81.

Connor W. Sullivan and Khusboo Desai. Classifications in brief: Mayo Classification of olecranon fractures. Clin Orthop Relat Res. 2019;477(4):908-10.

Morrey BF, Adams RA. Semiconstrained arthroplasty for the treatment of rheumatoid arthritis of the elbow. J Bone Joint Surg (Am). 1992;74:479-90.

Bruggemann A, Mukka S, Wolf O. Swedish fracture register. Eur J Trauma Emerg Surg. 2021.

Hume MC, Wiss DA, Olecranon fractures. Clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop Relat Res. 1992;285:229-35.

Fan G, Wu CC, Shin CH. Olecranon fractures with tension band wiring techniques - comparison among three different configurations. Chang Gung Medical Journal. 1993;16:231-8.

Anani A. The Annals Of African Surgery. 2011;8.

Suthar AY. International Journal of Health and Clinical Research. 2020;3(6):26-35.

Murphy DF, Greene WB, Damerson TB. Displaced olecranon fractures in adults. Clinical evaluation. Clin Orthop. 1987;224:215-23.

Xieyuan J. Operative treatment of olecranon fracture associated with anterior dislocation of the elbow. Chinese J of Orthop. 2000;20(3):154-6.

Aher DK, Pandey SK, Alawa S, Pathak A. Evaluation of functional outcome of tension band wiring in olecranon fractures and factors effecting the overall functional outcome. Int J Orthop Sci. 2018;4(2):334-6.