title: Malpositioned olecranon fracture tension-band wiring results in proximal radioulnar synostosis.
abstract: BACKGROUND
  Tension-band wiring (TBW) is a well-established fixation technique for two-part, transverse fracture types of the olecranon. However, complication rates up to 80 % are reported. By reporting on the enormous impact on the patient if failed the aim of the present report was to emphasize the importance of correct K wire positioning in TBW.
  
  
  METHODS
  We present the case of a 49-year-old woman who suffered from a radioulnar synostosis of the forearm due to malpositioned K wires after TBW treatment. The patient was treated by heterotopic bone resection supported by ossification prophylaxis (radiotherapy and Indomethacin). At follow-up of 12 months after revision surgery, elbow motion was unrestricted with a strength grade 5/5. The patient was free of pain and reported no restrictions in daily as well as sporting activities. Radiologic assessment showed no recurrence of heterotopic bone tissue.
  
  
  CONCLUSIONS
  Intraoperative radiographic and clinical examination of the elbow is highly recommended to identify incorrect hardware positioning and, therefore, to avoid serious postoperative complications in TBW.
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. lukas.willinger@gmx.at.
authors.forename: Lukas
authors.initials: L
authors.lastname: Willinger
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. martin.lucke@mri.tum.de.
authors.forename: Martin
authors.initials: M
authors.lastname: Lucke
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. moritz.croenlein@mri.tum.de.
authors.forename: Moritz
authors.initials: M
authors.lastname: Crönlein
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. gunther.sandmann@mri.tum.de.
authors.forename: Gunther H
authors.initials: GH
authors.lastname: Sandmann
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. peter.biberthaler@mri.tum.de.
authors.forename: Peter
authors.initials: P
authors.lastname: Biberthaler
authors.affiliation: Department of Trauma Surgery, Klinikum rechts der Isar, Technical University Munich, Ismaningerstr. 22, 81675, Munich, Germany. sebastian.siebenlist@mri.tum.de.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Siebenlist
mesh_terms: D005260:Female; D005593:Fracture Fixation, Internal / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries* / Q000601:surgery; D011182:Postoperative Care; D011300:Preoperative Care; D011884:Radius / Q000002:abnormalities*; D013580:Synostosis / Q000209:etiology*; D014457:Ulna / Q000002:abnormalities*; D014458:Ulna Fractures / Q000601:surgery*