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. 2017 Sep;18(3):275-281.
doi: 10.1007/s10195-017-0450-2. Epub 2017 Feb 28.

Tension band wiring for simple olecranon fractures: evaluation of surgical technique

Femke M A P Claessen  1 , Michel P J van den Bekerom  2 , C Niek van Dijk  3 , J Carel Goslings  4 , Gino M M J Kerkhoffs  5 , Job N Doornberg  6 ; Shoulder elbow platform
Collaborators, Affiliations

Tension band wiring for simple olecranon fractures: evaluation of surgical technique

Femke M A P Claessen et al. J Orthop Traumatol. 2017 Sep.

Erratum in

Abstract

Background: In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes.

Materials and methods: Forty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman's rank correlation test.

Results: None of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found.

Conclusions: A rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment.

Level of evidence: Level IV diagnostic study.

Keywords: Disability; Elbow trauma; Olecranon fracture; Technique pain; Tension band.

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Conflict of interest statement

Conflict of interest

There are no non-financial competing interests (political, personal, religious, ideological, academic, intellectual, commercial or any other) to declare in relation to this manuscript.

Patient consent

Obtaining the informed consent from involved patients was waived by the Research Ethics Committee.

Ethical approval

All procedures involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments. The study was approved by the Research Ethics Committee.

Figures

Fig. 1
Fig. 1
Antero–posterior and lateral radiograph of a simple olecranon fracture. It can be conflicting if twisted ends of the wire knot were sufficiently bent back into direct contact with the bone
Fig. 2
Fig. 2
Antero–posterior and lateral radiograph of a simple olecranon fracture. It can be conflicting if the Kirschner wires were oversized in term of length and if twisted ends of the wire knot were sufficiently bent back into direct contact with the bone
See this image and copyright information in PMC

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