Current techniques for management of transverse displaced olecranon fractures.
BACKGROUND
displaced transverse fractures of the olecranon are the most common fractures occurring in the elbow in adults that requires operative intervention.


METHODS
a literature search was performed on PubMed, Web of Science, Science Direct/Scopus, Google Scholar and Google using the keywords 'olecranon', 'fracture', 'internal fixation' and 'tension band wiring', with no limit for time or restrictions to language.


RESULTS
thirty-one clinical articles were selected: 20 retrospective studies, 9 prospective cohort studies, and 2 randomized control trials. The CMS ranged from 18 to 66 (mean 41.68): overall, the quality of the studies was poor, and no moderate or good quality studies were found. The mean follow-up was 46.7 months (range 1 to 350 months). Several complications occurred after surgery: prominent hardware, skin breakdown, wire migration and infections occurred frequently. Removal of the hardware was required in 472 patients, usually after complaints, but also removal was routinely undertaken.


CONCLUSIONS
tension band wiring is still the most widely applied method to operatively manage olecranon fractures, with the transcortical method of using K-wires the most satisfactory. Plate fixation is a good alternative as complications are minimal. Other techniques using absorbable sutures are less investigated, but are promising, especially in children.
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
Anniek
A
den Hamer
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
Maarten
M
Heusinkveld
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
Willeke
W
Traa
Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands.
Pim
P
Oomen
Department of Orthopaedics, Tor Vergata University, Rome, Italy.
Francesco
F
Oliva
Department of Orthopaedic and Trauma Surgery Hospital Antonio Cardarelli, Campobasso, Italy.
Angelo
A
Del Buono
Queen Mary University of London, Centre for Sports and Exercise Medicine, Mile End Hospital, Mann Ward, London, England; Department of Musculoskeletal Disorders, University of Sabino School of Medicine and Surgery, Sabino, Italy.
Nicola
N
Maffulli
displaced olecranon fractures; outcomes; surgery; systematic review