Functional Outcomes Following Plating or Tension Band Wiring of Olecranon Fractures

To evaluate the outcome following internal fixation of olecranon fractures using the techniques of tension band wiring and plating. Design: retrospective evaluation. Setting: regional trauma center. 48 consecutive patients with fractures of the olecranon were treated over a 20- month period (May 1993 to December 1994). Analyses of the results were based on the medical records, preand postoperative radiographs of all 48 patients and clinical review of 39 patients at a mean follow-up of > 2 years (range 28–48 months). Intervention: 25 fractures were fixed using the AO tension band-wiring technique and 23 were fixed with a plate; the selection of method was based on agreed radiologic fracturepattern criteria. Main outcome measurements: radiographic evaluation of the quality of reduction was carried out using a grading system. Clinical outcome was assessed using the Broberg & Morrey functional rating index. Clinical evaluation of 39 patients was carried out. In the tension band-wiring group, 17 (85%) patients had an excellent or good outcome and eleven (55%) patients underwent a second procedure for symptomatic metalwork. In the plating group, 16 (84%) patients had an excellent or good outcome and two (11%) patients underwent a second procedure for symptomatic metalwork. The latter group had more complex and associated fractures and included the only poor result. Internal fixation of fractures of the olecranon results in good functional outcome. Patients who have tension band wiring more often require a second procedure for removal of symptomatic metalwork.