title: A survey of current practices and preferences for internal fixation of displaced olecranon fractures.
abstract: BACKGROUND
  Olecranon fractures represent 10% of upper extremity fractures. There is a growing body of literature to support the use of plate fixation for displaced olecranon fractures. The purpose of this survey was to gauge Canadian surgeons' practices and preferences for internal fixation methods for displaced olecranon fractures.
  
  
  METHODS
  Using an online survey tool, we administered a cross-sectional survey to examine current practice for fixation of displaced olecranon fractures.
  
  
  RESULTS
  We received 256 completed surveys for a response rate of 31% (95% confidence interval [CI] 30.5-37.5%). The preferred treatment was tension band wiring (78.5%, 95% CI 73-83%) for simple displaced olecranon fractures (Mayo IIA) and plating (81%, 95% CI 75.5-85%) for displaced comminuted olecranon fractures (Mayo IIB). Fracture morphology with a mean impact of 3.31 (95% CI 3.17-3.45) and comminution with a mean impact of 3.34 (95% CI 3.21-3.46) were the 2 factors influencing surgeons' choice of fixation method the most. The major deterrent to using tension band wiring for displaced comminuted fractures (Mayo IIB) was increased stability obtained with other methods described by 75% (95% CI 69-80%) of respondents. The major deterrent for using plating constructs for simple displaced fractures (Mayo IIA) was better outcomes with other methods. Hardware prominence was the most commonly perceived complication using either method of fixation: 77% (95% CI 71.4-81.7%) and 76.2% (95% CI 70.6-81.0%) for tension band wiring and plating, respectively.
  
  
  CONCLUSIONS
  Divergence exists with current literature and surgeon preference for fixation of displaced olecranon fractures.
authors.affiliation: From the Michael G. DeGroote School of Medicine, McMaster University (Thomas); the Department of Surgery, McMaster University (Wood, Farrokhyar, Ristevski, Bhandari, Petrisor); the Division of Orthopedic Surgery, McMaster University (Wood, Ristevski, Bhandari, Petrisor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. (Farrokhyar).
authors.forename: Thomas
authors.initials: T
authors.lastname: Wood
authors.affiliation: From the Michael G. DeGroote School of Medicine, McMaster University (Thomas); the Department of Surgery, McMaster University (Wood, Farrokhyar, Ristevski, Bhandari, Petrisor); the Division of Orthopedic Surgery, McMaster University (Wood, Ristevski, Bhandari, Petrisor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. (Farrokhyar).
authors.forename: Katie
authors.initials: K
authors.lastname: Thomas
authors.affiliation: From the Michael G. DeGroote School of Medicine, McMaster University (Thomas); the Department of Surgery, McMaster University (Wood, Farrokhyar, Ristevski, Bhandari, Petrisor); the Division of Orthopedic Surgery, McMaster University (Wood, Ristevski, Bhandari, Petrisor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. (Farrokhyar).
authors.forename: Forough
authors.initials: F
authors.lastname: Farrokhyar
authors.affiliation: From the Michael G. DeGroote School of Medicine, McMaster University (Thomas); the Department of Surgery, McMaster University (Wood, Farrokhyar, Ristevski, Bhandari, Petrisor); the Division of Orthopedic Surgery, McMaster University (Wood, Ristevski, Bhandari, Petrisor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. (Farrokhyar).
authors.forename: Bill
authors.initials: B
authors.lastname: Ristevski
authors.affiliation: From the Michael G. DeGroote School of Medicine, McMaster University (Thomas); the Department of Surgery, McMaster University (Wood, Farrokhyar, Ristevski, Bhandari, Petrisor); the Division of Orthopedic Surgery, McMaster University (Wood, Ristevski, Bhandari, Petrisor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. (Farrokhyar).
authors.forename: Mohit
authors.initials: M
authors.lastname: Bhandari
authors.affiliation: From the Michael G. DeGroote School of Medicine, McMaster University (Thomas); the Department of Surgery, McMaster University (Wood, Farrokhyar, Ristevski, Bhandari, Petrisor); the Division of Orthopedic Surgery, McMaster University (Wood, Ristevski, Bhandari, Petrisor); and the Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ont. (Farrokhyar).
authors.forename: Bradley
authors.initials: B
authors.lastname: Petrisor
mesh_terms: D002170:Canada; D005593:Fracture Fixation, Internal / Q000379:methods* / Q000706:statistics & numerical data; D018460:Fractures, Comminuted / Q000601:surgery*; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D056740:Olecranon Process / Q000293:injuries* / Q000601:surgery; D009985:Orthopedics / Q000379:methods*; D011795:Surveys and Questionnaires; D014458:Ulna Fractures / Q000601:surgery*