title: Olecranon fractures: factors influencing re-operation.
abstract: OBJECTIVE
  We evaluated factors influencing re-operation in tension band and plating of isolated olecranon fractures.
  
  
  METHODS
  Four hundred eighty-nine patients with isolated olecranon fractures who underwent tension band (TB) or open reduction internal fixation (ORIF) from 2003 to 2013 were identified at an urban level 1 trauma centre. Medical records were reviewed for patient information and complications, including infection, nonunion, malunion, loss of function or hardware complication requiring an unplanned surgical intervention. Electronic radiographs of these patients were reviewed to identify Orthopaedic Trauma Association (OTA) fracture classification and patients who underwent TB or ORIF.
  
  
  RESULTS
  One hundred seventy-seven patients met inclusion criteria of isolated olecranon fractures. TB was used for fixation in 43 patients and ORIF in 134. No statistical significance was found when comparing complication rates in open versus closed olecranon fractures. In a multivariate analysis, the key factor in outcome was method of fixation. Overall, there were higher rates of infection and hardware removal in the TB compared with the ORIF group.
  
  
  CONCLUSIONS
  Our results demonstrate that the dominant factor driving re-operation in isolated olecranon fractures is type of fixation. When controlling for all variables, there is an increased chance of re-operation in patients with TB fixation.
authors.affiliation: The Vanderbilt Orthopaedic Institute Center for Health Policy, 1215 21st Avenue South, Suite 4200 Medical Center East, South Tower, Nashville, TN, 37232, USA.
authors.forename: Mark Christopher
authors.initials: MC
authors.lastname: Snoddy
authors.forename: Maximilian Frank
authors.initials: MF
authors.lastname: Lang
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: An
authors.forename: Phillip Michael
authors.initials: PM
authors.lastname: Mitchell
authors.forename: William Jeffrey
authors.initials: WJ
authors.lastname: Grantham
authors.forename: Benjamin Scoot
authors.initials: BS
authors.lastname: Hooe
authors.forename: Harrison Ford
authors.initials: HF
authors.lastname: Kay
authors.forename: Ritwik
authors.initials: R
authors.lastname: Bhatia
authors.forename: Rachel V
authors.initials: RV
authors.lastname: Thakore
authors.forename: Jason Michael
authors.initials: JM
authors.lastname: Evans
authors.forename: William Todd
authors.initials: WT
authors.lastname: Obremskey
authors.forename: Manish Kumar
authors.initials: MK
authors.lastname: Sethi
mesh_terms: D000328:Adult; D004868:Equipment Failure / Q000706:statistics & numerical data; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects* / Q000379:methods*; D005593:Fracture Fixation, Internal / Q000009:adverse effects* / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery*; D017759:Fractures, Malunited / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries*; D011183:Postoperative Complications / Q000453:epidemiology; D012086:Reoperation; D012189:Retrospective Studies; D013530:Surgical Wound Infection / Q000453:epidemiology; D016896:Treatment Outcome