title: Transverse fractures of the olecranon: a biomechanical comparison of three fixation techniques.
abstract: BACKGROUND
  The gold standard for treating transverse olecranon fractures is tension band fixation. A problem with this technique is migration of the K-wires leading to premature hardware removal. The aim of this study is to compare stability provided by two new techniques designed to eliminate the problem with backing out of K-wires, with that of the recommended tension band technique, performed with a biomechanical in vitro investigation. Our hypothesis was that the two new techniques would provide at least equal stability as the traditional tension band fixation.
  
  
  METHODS
  Transverse olecranon osteotomies were created in human cadaveric elbows to simulate a type 21-B1.1 fracture. Three groups of 8 specimens were instrumented with: (1) recommended AO tension band technique; (2) modified K-wires with eyelets and tension band; (3) staples across the fracture with tension band. Each elbow was tested in a 90° flexed position. The triceps tendon was sinusoidally loaded by applying two load steps at 500 and 700 N for 4000 cycles each. Relative movements between the fragments were determined.
  
  
  RESULTS
  At the end of the first and second load step the displacement of the osteotomy at the posterior ulnar side was significantly less for the staples across the fracture with tension band as compared to both other groups. There were no significant differences between groups 1 and 2.
  
  
  CONCLUSIONS
  Since clinical results depend partly on stable fixation, it is concluded that using staples in the clinical situation might provide better results than the currently recommended tension band technique.
authors.affiliation: University Hospital Geneva, 24 Rue Micheli-du-Crest, 1211 Geneva 14, Switzerland.
authors.forename: Hassan
authors.initials: H
authors.lastname: Sadri
authors.forename: Richard
authors.initials: R
authors.lastname: Stern
authors.forename: Michael
authors.initials: M
authors.lastname: Singh
authors.forename: Berend
authors.initials: B
authors.lastname: Linke
authors.forename: Pierre
authors.initials: P
authors.lastname: Hoffmeyer
authors.forename: Karsten
authors.initials: K
authors.lastname: Schwieger
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001864:Bone Wires; D005260:Female; D050723:Fractures, Bone / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007593:Joint Instability / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries*; D013537:Sutures