title: Olecranon tension plating or olecranon tension band wiring? A comparative biomechanical study.
abstract: OBJECTIVE
  The complication rate of a tension band wiring (TBW) used for the internal fixation of olecranon fractures remains high. The aim of this study was to compare the stability of a novel olecranon tension plate (OTP) with TBW in a simulated fracture model.
  
  
  METHODS
  We tested 12 fresh frozen-pairs of cadaver proximal ulnae treated with OTP and TBW under cyclic loading. The elbow motion ranged from full extension to 90° of flexion, and the pulling force of the triceps tendon ranged from 50 to 350 N. The displacement of the fracture fragments was measured continuously. Data were assessed statistically using the Wilcoxon test with significance level of p < 0.05.
  
  
  RESULTS
  The cyclic loading tests showed median displacements of the fracture fragments of 0.25 mm using OTP and 1.12 mm for TBW. Statistical analysis showed the difference to be substantial (p = 0.086) but not statistically significant. No plate breakage or screw loosening occurred.
  
  
  CONCLUSIONS
  The concept of replacing prominent K-wires at the proximal end of the ulna using an low-profile plate with classical lag and multidirectional angle-stable screws demonstrated biomechanical advantages over TBW.
authors.affiliation: Department of Orthopaedics and Traumatology, University Medical Center, Mainz, Germany, dominik.gruszka@unimedizin-mainz.de.
authors.forename: Dominik
authors.initials: D
authors.lastname: Gruszka
authors.forename: Charlotte
authors.initials: C
authors.lastname: Arand
authors.forename: Tobias
authors.initials: T
authors.lastname: Nowak
authors.forename: Sven-Oliver
authors.initials: SO
authors.lastname: Dietz
authors.forename: Daniel
authors.initials: D
authors.lastname: Wagner
authors.forename: Pol
authors.initials: P
authors.lastname: Rommens
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001696:Biomechanical Phenomena; D001860:Bone Plates / Q000009:adverse effects*; D001864:Bone Wires / Q000009:adverse effects*; D002102:Cadaver; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D050723:Fractures, Bone / Q000601:surgery; D006801:Humans; D008875:Middle Aged; D056740:Olecranon Process / Q000601:surgery*; D016059:Range of Motion, Articular; D014458:Ulna Fractures / Q000601:surgery*