title: Double tension band wiring for treatment of olecranon fractures.
abstract: OBJECTIVE
  Although tension band wiring (TBW) is generally accepted as standard treatment for olecranon fractures, it has several shortcomings such as loss of reduction, skin irritation, and migration of the K-wires. To overcome these problems and increase fixation stability, we used a rigid fixation technique with double tension band wiring (DTBW). Here, we describe the technique and outcomes of the treatment.
  
  
  METHODS
  We retrospectively reviewed 21patients with olecranon fractures who were treated by DTBW. We evaluated clinical and radiological outcomes by checking the range of motion, loss of reduction, functional scoring, skin complications, and pin migration. There were 15 cases of Mayo type IIA fractures (71%) and 6 of type IIB fractures (29%). The mean follow-up period was 37 months (range, 12-58 mo). We also compared the mechanical stability of DTBW and TBW in a sawbone model using a single cycle load to failure protocol.
  
  
  RESULTS
  All fractures united without displacement, and no migration of the K-wires was observed during the period of follow-up. Mean loss of elbow extension was 2° (range, 0°-15°) and mean elbow flexion was 134° (range, 125°-140°). The mean Mayo Elbow Performance Score was 94 (range, 70-100). Biomechanical testing revealed greater mechanical strength in the DTBW technique than in the TBW when measured by mean maximum failure load and mean bending moment at failure.
  
  
  CONCLUSIONS
  DTBW produced good clinical and radiological outcomes and could be an effective option for the treatment of olecranon fractures by providing additional stability through a second TBW. Biomechanical comparison with a control group (TBW) supported the mechanical benefits of DTBW.
  
  
  METHODS
  Therapeutic IV.
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University, Gyeonggi-do, South Korea.
authors.forename: Wanlim
authors.initials: W
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University, Gyeonggi-do, South Korea.
authors.forename: Sunghun
authors.initials: S
authors.lastname: Choi
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University, Gyeonggi-do, South Korea.
authors.forename: Jun O
authors.initials: JO
authors.lastname: Yoon
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University, Gyeonggi-do, South Korea.
authors.forename: Ho Youn
authors.initials: HY
authors.lastname: Park
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University, Gyeonggi-do, South Korea.
authors.forename: Sun Hwa
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Department of Orthopaedic Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea; Department of Orthopaedic Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, Catholic University, Gyeonggi-do, South Korea. Electronic address: micro@amc.seoul.kr.
authors.forename: Jin Sam
authors.initials: JS
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001858:Bone Nails; D001864:Bone Wires; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D050723:Fractures, Bone / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries / Q000601:surgery*; D011183:Postoperative Complications; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000601:surgery*
keywords: Olecranon fracture; double tension band wiring