Internal Fixation of Olecranon Fracture Using Four Loops of High Tensile Braided Suture Tension Band

Background: Olecranon fractures are common injuries that often require surgical intervention. Traditional fixation methods, such as tension band wiring and plate fixation, are effective but frequently associated with complications including hardware prominence, pain, and the need for hardware removal. Our question is ‘Does the high tensile braided suture tension band have the same effect as traditional wires in internal fixation of Mayo Type 2A olecranon fractures with lower rate of subsequent hardware removal?’.Patients and Methods: Twenty patients with displaced Mayo Type 2A olecranon fractures underwent surgical fixation using a high-tensile braided suture tension band. Postoperative management included broad arm sling with encouragement for the patients to start early mobilization within the first week as pain was tolerated to enhance recovery while protecting the repair. Clinical outcomes were measured using the Mayo Elbow Performance Score (MEPS), and radiological evaluations were conducted to monitor fracture healing and maintenance of reduction.Results: A total of 18 patients achieved satisfactory fracture union without significant loss of reduction or fixation failure. Two patients showed the failure of reduction resulted from falling on their elbows 1 month and one and half months postoperative. The other 18 patients reported excellent or good outcomes on the Mayo Elbow Performance Score, with minimal pain and functional limitations. Notably, there were no hardware-related issues such as prominence or irritation in all 18 patients. No infections or adverse soft tissue reactions were observed.Conclusions: The four-loop high-tensile braided suture technique for internal fixation of Mayo Type 2A olecranon fractures appears to be a promising alternative to traditional metal fixation methods with a reduced risk of hardware-related complications.