PURPOSE: To evaluate the clinical and radiographic outcomes of tension band wiring of displaced olecranon fractures treated using Kirschner wires with eyelets to assess their clinical performance with respect to complications such as backing out of the K-wires, restriction of forearm rotation, and neurovascular injury. METHODS: The authors retrospectively reviewed 44 patients treated for an isolated, displaced olecranon fracture and checked range of motion, postoperative pain, complications, and incidence of hardware removal. The mean follow-up period was 41 months (range, 26-73 mo). RESULTS: All fractures united, and anatomical reduction was achieved in all cases at final follow-up. Mean elbow flexion was 135° (range, 115° to 140°), and mean elbow extension was 4° (range, 0° to 15°). No pin migration, restriction of forearm rotation, or neurovascular injury occurred. Hardware removal was performed in 8 cases (18%). Compared to previous results with conventional Kirschner wires, no meaningful improvement in postoperative pain level or in the rate of hardware removal was observed. CONCLUSIONS: Tension band wiring using the pin studied produced excellent clinical and radiologic outcomes for the treatment of isolated, displaced Mayo type IIA and some type IIB olecranon fractures. The pin was effective in preventing the backing out of Kirschner wires and avoiding the complications associated with anterior cortical engagement of Kirschner wires, such as neurovascular injury or restriction of forearm rotation.
PURPOSE: To evaluate the clinical and radiographic outcomes of tension band wiring of displaced olecranon fractures treated using Kirschner wires with eyelets to assess their clinical performance with respect to complications such as backing out of the K-wires, restriction of forearm rotation, and neurovascular injury. METHODS: The authors retrospectively reviewed 44 patients treated for an isolated, displaced olecranon fracture and checked range of motion, postoperative pain, complications, and incidence of hardware removal. The mean follow-up period was 41 months (range, 26-73 mo). RESULTS: All fractures united, and anatomical reduction was achieved in all cases at final follow-up. Mean elbow flexion was 135° (range, 115° to 140°), and mean elbow extension was 4° (range, 0° to 15°). No pin migration, restriction of forearm rotation, or neurovascular injury occurred. Hardware removal was performed in 8 cases (18%). Compared to previous results with conventional Kirschner wires, no meaningful improvement in postoperative pain level or in the rate of hardware removal was observed. CONCLUSIONS: Tension band wiring using the pin studied produced excellent clinical and radiologic outcomes for the treatment of isolated, displaced Mayo type IIA and some type IIB olecranon fractures. The pin was effective in preventing the backing out of Kirschner wires and avoiding the complications associated with anterior cortical engagement of Kirschner wires, such as neurovascular injury or restriction of forearm rotation.
Authors: Femke M A P Claessen; Yvonne Braun; Rinne M Peters; George Dyer; Job N Doornberg; David Ring Journal: Clin Orthop Relat Res Date: 2015-08-07 Impact factor: 4.176