Title : Tension band suture fixation for olecranon fractures: Intra operative decision making in comminuted fractures
Abstract:
Introduction: In 2017 Phadnis and Watts presented the first all-suture technique for olecranon fracture fixation. The key benefit of this new technique was the absence of metalwork, which frequently causes symptoms for patients requiring re-operation for removal. In this study, we sought to demonstrate the validity of the technique and to determine if the indications for using this could be extended.
Methods: We analysed all olecranon fixation procedures over a two-year period from 2022 to 2024. Specifically looking at fracture pattern, surgical technique and the rates of complications.
Results: A total of 32 tension band suture fixations were performed over this period, with a complication rate of 15% and a re-operation rate of 9%. Analysis of fracture pattern on initial imaging demonstrated that the technique can be successful for patients with comminution at either the near or far cortex with 18% and 14% complication rate respectively. In contrast, operative technique was observed to be much more important for final outcome, with gap at the fracture site intraoperatively giving a 50% non-union rate.
Conclusions: Our study validates the tension band suture fixation technique for olecranon fracture fixation as safe and effective. We have also demonstrated that this technique could be used in olecranon fractures with limited comminution, using our intra operative screening method to decide between tension suture fixation and plate fixation.
