Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations.
BACKGROUND
To assess clinical and functional outcomes as well as the relative stability of various configurations of tension band wiring approaches for treating olecranon fractures, a retrospective cohort study was conducted.


METHODS
Seventy-seven consecutive adult patients with 78 olecranon fractures were treated using tension band wiring techniques in three different configurations. The configurations differed in the location of the ends of Kirschner wires with the following locations being used: in the proximal ulnar canal, through the anterior ulnar cortex, and in the distal ulnar canal.


RESULTS
Based on average follow-up of 2.76 years (range, 1.1-5.5 years), all three techniques achieved high union rates and low complication rates. However, the Kirschner wires in the first technique allowed proximal pin migration with elbow irritation as compared with the second and the third techniques (p = 0.001, 0.03, respectively).


CONCLUSIONS
Placement of the ends of Kirschner wires in the proximal ulnar canal should be avoided whenever possible. Because placement of the ends of Kirschner wires through the anterior ulnar cortex may produce serious complications as reported in medical literature, placement of the ends of Kirschner wires in the distal ulnar canal may be the most effective approach.
Huang
Tsan-Wen
TW
Department of Orthopaedics, Chang Gung Memorial Hospital, Chang Gung University, Taoyuan, Taiwan.
Wu
Chi-Chuan
CC
Fan
Kuo-Feng
KF
Tseng
I-Chuan
IC
Lee
Po-Cheng
PC
Chou
Ying-Chao
YC
D000293:Adolescent; D000328:Adult; D000368:Aged; D001864:Bone Wires / Q000009:adverse effects; D020878:Device Removal; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D017102:Fracture Healing; D006801:Humans; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries*; D014458:Ulna Fractures / Q000601:surgery*; D055815:Young Adult