Loop anchor tension band wiring for olecranon fractures reduces Kirschner wire migration rate: a retrospective comparative study

The loop anchor tension band wiring (TBW) technique is employed for olecranon fractures and aims to reduce the Kirschner wire (K-wire) migration rate. This study compared the postoperative outcomes and complication rates of olecranon fractures treated with Arbeitsgemeinschaft für Osteosynthesefragen (AO)-modified TBW versus the loop anchor TBW. This study enrolled 83 olecranon fractures treated with AO-modified TBW (n = 62) or loop anchor TBW (n = 21). K-wire migration, implant removal, time to fracture union, operation time, and subjective functional outcomes including the Mayo Elbow Performance Score and Quick Disabilities of the Arm, Shoulder and Hand Score (Quick-DASH). Subgroup analysis by fracture classification (Mayo IIA and IIB) was performed. The follow-up duration was 10.2 ± 5.6 (6.0–43.6) months. The incidence of posterior migration of K-wires was 61.3% and 4.8% in the traditional and loop anchor TBW groups, respectively (P < .001). The operation time was 50.3 ± 6.5 and 36.2 ± 3.2 min in the traditional and loop anchor TBW groups, respectively (P < .001). The posterior elbow irritation rate was significantly lower in the loop anchor TBW group (23.8%) than in the traditional group (50.0%; P = .036). Other relevant parameters were not significantly different between the groups during the follow-up period. The loop anchor tension band technique results in a lower K-wire migration rate, a lower posterior elbow irritation rate, and shorter operation duration than does AO-modified TBW while achieving similar functional outcomes.