Functional and radiological outcome: Olecranon tension band wiring vs plating

Background: Olecranon fractures represent one of the frequently encountered injuries of the upper limb, especially among adults and the elderly population. When these fractures are displaced, surgical intervention becomes the preferred line of treatment, with plate osteosynthesis (PO) as well as tension band wiring (TBW) being the two most widely practiced methods. The present prospective study evaluates and compares clinical, functional, and radiological outcomes, along with the incidence of postoperative complications and the need for revision surgeries, in patients suffering from more complex fractures and Mayo type IIA treated by either TBW or PO. Methods: 17 individuals suffering from olecranon fractures were treated by PO or TBW at our institution were included in this study. Their demographic details, survey responses, and clinical findings were recorded, analyzed, and reviewed. All patients were admitted through the outpatient department (OPD) or the emergency department of Amaltas Hospital. Functional outcomes were evaluated with help of range of motion (ROM) along with 3 validated scoring systems: “the American Shoulder and Elbow Surgeons Standardized Elbow Assessment score (pASES-e), the Mayo Elbow Performance Score (MEPS), and the Disabilities of the Arm, Shoulder and Hand (DASH) score”. Results: Of the 17 patients, 12 (70.58%) underwent TBW, while 5 (29.41%) were treated with PO. The mean pASES-e, MEPS, and DASH scores were 75.1 ± 19.2, 75.6 ± 15.3, and 21 ± 21.7 respectively, in the PO group and 83.6 ± 12.4, 80.5 ± 14.7, and 14.5 ± 17.2, in TBW group, (p=0.03, p=0.17, and p=0.16). Average surgery duration along with hospital stay were lengthier in PO group (p=0.002, p = 0.37). Conversely, complications, nonunion, along with malunion rates were higher in the TBW group (p=0.24, p=0.15). Conclusions: As per existing literature, both tension band wiring (TBW) as well as plate fixation (PF) are considered effective surgical choices for management of displaced, isolated, simple olecranon fractures. Our conclusions are consistent with these reports, demonstrating good to excellent outcomes with no statistically substantial variances amid the 2 techniques.