Tension band wiring techniques are the mainstay of treatment for transverse, noncomminuted, olecranon fractures, but they may also be used in some comminuted fracture patterns. The authors describe here the evaluation, fracture fixation technique, postoperative protocol, and tension band principle in a 26yearold male who sustained a closed transverse twopart fracture of olecranon without distal neurovascular deficit. Olecranon fracture orif with tension band trauma orthobullets. The aim of this singlecenter, singleblinded, prospective randomized trial was to compare the outcomes of tensionband wire tbw and plate fixation for simple isolated, displaced fractures of the olecranon. The eligible studies were acquired from pubmed, cnki, embase, cochrane. To compare mean change in the mayo elbow performance score in olecranon fracture after treatment with tension band wiring and locking compression plate. Tension band wiring and pinning for the management of olecranon fracture in a dog. Aim of this long term retrospective study was to evaluate the elbow function and the patientrated outcome after tbw fixation of olecranon fractures. Several variations of tension band wiring have been advocated. Olecranon fracture of is a common upper limb fracture, and the most commonly used techniques are still tension band wiring tbw and plate fixation pf. Functional outcome of tension band wiring in transverse. Wires are used as tension band most commonly in patella and olecranon fractures. Tension band wiring is an optimal mechanical principle for early functional motion.
The complication rate of a tension band wiring tbw used for the internal fixation of olecranon fractures remains high. The most frequent operative methods for fixation of a displaced fracture are tension band wiring tbw and plate fixation pf. Olecranon definition of olecranon by medical dictionary. Tension band wire fixation continues to be the most popular method of fixation for displaced olecranon fractures despite several biomechanical. Plate fixation and tension band wiring after isolated. Olecranon fractures are one of the most commonly seen orthopaedic injuries in the emergency room. Tension band wiring tbw is a wellestablished fixation technique for twopart, transverse fracture types of the olecranon. Explain the principle of tension band wiring sum up. Surgical management for olecranon fractures in adults. A trial of plate fixation versus tension band wire for olecranon fractures the safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Definition warning indicates critical information about a potential serious outcome to the patient or the user.
The tension band principle as applied to transverse olecranon fractures fixed by tension band wiring is based on the premise that distraction forces on the outer cortex of the ulna during elbow flexion are converted to compression forces on the articular surface of the olecranon at the fracture site. Tension band fixation of olecranon fracture step by step. Tensionband wire tbw fixation is commonly employed for simple isolated stable displaced fractures of the olecranon type iia according to the mayo. However, complication rates up to 80 % are reported. Tension band wiring for avulsion fracture of olecranon in a dog applied and movement was restricted for three weeks. Tension band wiring definition of tension band wiring by. Tension suture fixation olecranon fractures vumedi. Other indications are tuberosity of the humerus, of the lateral and medial.
I was back at work after 3 12 months and the range of motion since then has not changed much and actually gotten worse due to an infection lingering in hardware and the need for another surgery a month back to remove the wirenot pinsthat being said the pins are typically removed 36 months. Efficacy and safety of tension band wiring versus plate. Tension band wiring of olecranon fractures has been shown to be associated with a high rate of metalwork removal. The vast majority are treated with two operation techniques. The tension band converts tensile forces on the posterior aspect of the olecranon into compression forces at the joint line. Tension band wiring tbw remains the most common operative technique for the internal fixation of olecranon fractures despite the potential occurrence of subjective complaints due to subcutaneous position of the hardware. Wolfgang g, burke f, bush d, parenti j, perry j, lafollette b, et al. Surgical options tension band wiring commonly used for noncomminuted, transverse olecranon fractures. Tension band wiring versus locking plate fixation for simple, twopart mayo 2a olecranon fractures. Plate versus tensionband wire fixation for olecranon. N2 we encountered a high incidence of complications related to the technique of tensionband wire fixation of displaced fractures of the olecranon in a fiveyear retrospective study of twenty patients twenty fractures. Olecranon fracture and flexion elbow problems forums. Olecranon fracture orif with tension band olecranon fracture orif with plate fixation radial head fracture mason type 2 orif tplate and kocher approach radial head fx replacement radial head fx excision withwithout interposition allograft.
We help you select the appropriate treatment of ulna, articular, olecranon located in our module on proximal forearm. Orthopedics a format for orthopedic wiring of fracture fragments either alone or with a screw or kirschner wire to force fragments together in compression. The kwire which is used in the ao tension band wiring tbw technique resists the shear better than the figure of eight wire alone, but, it does not add compression to the fixation strength. Tensionband wire fixation of olecranon fractures leads to a high reoperation rate because of the need to remove the metalware. Multifragmentary fractures cannot be fixed with a tension band. In contrast, plate fixation is thought to provide superior outcomes for unstable comminuted olecranon fractures. In contrast to the prevailing opinion, several case reports highlight major risks, such as damage to the median and anterior interosseous nerves. The purpose of this study was to investigate whether this remained true or whether there had been a reduction in metalwork removal following improvements in surgical technique. Tension band wiring for avulsion fracture of olecranon in. The objective of this study is to compare the outcomes of surgically treated olecranon fractures with plate fixation or. A trial of plate fixation versus tension band wire for.
Developed by renowned radiologists in each specialty, statdx provides comprehensive decision support you can rely on olecranon fracture. Thread tension band wire in figure of 8 around k wires screw and under triceps aponeurosis posteriorly. The fixation is simple and inexpensive and works well if executed properly. Depending on fracture stability motion will increase the interfragmentary compression. Principle of tension band wiring n its application 1. Pass the long segment of the wire bearing the loop in a figureofeight configuration beneath the triceps tendon around the protruding ends of the kwires. Tension band wiring of olecranon fractures mark bowen.
Complications and reoperation rate after tensionband wiring of. Olecranon tension plating or olecranon tension band wiring. Ao tensionband osteosynthesis of displaced olecranon. T1 complications of tensionband wiring of olecranon fractures. Early movement exercises are usually started within 1 week of surgery. Cancellous screw with tension band wiring for fractures of. To assess the functional outcome of tension band wiring in transverse fracture of olecranon process of ulna. Background tension band wiring of olecranon fractures has been shown to be associated with a high rate of metalwork removal. The philosophy behind the tension band for the olecranon is that it converts tensile forces on the posterior side of the olecranon into compression forces at the joint line during flexion. The incidence of olecranon fractures, especially in the elderly, is rising 1, 2.
Tension band wiring is a well proven method of treating olecranon fractures 14. Introduction tension band wiring tbw is the goal standard for simple non comminuted olecranon fractures. Principle of tension band wiring n its application. The tension band wiring implant takes tension and bone takes the compression. Aggressive elbow flexion rom for 46 weeks biceps strengthening for 6 weeks closed kinetic chain exercises for 68 weeks i. The acumed tension band pin system is intended to be used in tension band wiring procedures addressing malleolar, patellar, and olecranon fractures. For those olecranon fractures that are displaced, treatment typically involves anatomical reduction i. Olecranon definition of olecranon by the free dictionary. The tension band wiring tbw technique is a common treatment for the fixation of olecranon fractures with up to three fragments. Despite the literature reporting a high complication rate tension band wiring remains a common technique for the fixation of olecranon fractures.
Protect healing site for 46 weeks decrease paininflammation. Tension band wiring is a surgical technique that involves the use of two kirschner k wires, or pins, and a tension band wire in the form of a figure eight to secure the bone. Tension band wire tbw fixation is commonly employed for simple isolated stable displaced fractures of the olecranon type iia according to the mayo classification 35. Olecranon fracture orif with tension band olecranon fracture orif with plate fixation. Tension band wiring for simple olecranon fractures. Tension band wiring of olecranon fractures davies 2009. By reporting on the enormous impact on the patient if failed the aim of the present report was to emphasize the importance of correct k wire positioning in tbw.
A suture only technique for fixation of olecranon fractures and osteotomies avoiding the need for reoperation associated with tension band wiring. The literature and surgeons describe tbw as an uncomplicated, always available and convenient operation producing excellent results. The technique has however been shown to be associated with a high rate of secondary surgery with more than 60% of patients requiring metalwork removal 2, 3, 5, 11. The tension band converts the triceps tensile forces on the posterior side of the olecranon into compression forces at the joint line. Postoperative rehabilitation protocol following olecranon orif. Fixation of patellar fractures with tension band wiring was associated with a. Postoperative rehabilitation protocol following olecranon. The tension band principle as applied to transverse olecranon fractures fixed by tension band wiring tbw is based on the premise that distraction forces on the outer cortex of the ulna during elbow flexion are converted to compression forces on the.
The length of the kirschner wires is not especially emphasized, and in most cases, they are only placed proximal to the ulnar shaft. Tensionband wire tbw fixation is commonly employed for simple isolated stable displaced fractures of the olecranon type iia according to the mayo classification 35. Tension band wire for olecranon fracture touch surgery. Olecranon transverse fracture tbw tension band wir shirish karki. Listing a study does not mean it has been evaluated by the u. Olecranon tension band wiring cambridge orthopaedics. Plate versus tension band wire fixation for olecranon fractures. Operative treatment of olecranon fractures full text. Traditionally, isolated olecranon fractures have been treated with tension band wiring tbw. Pdf tension band wiring and pinning for the management.
Olecranon transverse fracture tbw tension band wir youtube. Wire migration and elbow pain related to the use of the kwires in this. The aim of the current study is to discuss whether tbw or pf technique of internal fixation is better in the treatment of ofs, using the method of metaanalysis. The aim of this study was to compare the stability of a novel olecranon. The tension band principle as applied to transverse olecranon fractures fixed by tension band wiring tbw is based on the premise that. In commonly used constructs, intramedullary k wires or an intramedullary screw, combined with either braided cable or monofilament wire, are used. There is a trend towards increased use of plate fixation, though tbw has yielded good and comparable patient reported outcomes. Olecranon fractures are common injuries in patients of any age. Malpositioned olecranon fracture tensionband wiring. Is tension band wiring technique the gold standard for. Displaced fractures have traditionally been treated operatively to reestablish the congruency of the ulnar jointsurface and to reattach the triceps tendon. Another occasional complication seen wid tension band wire for olecranon fracture is its cutting out of the distal fragment if the wire is not inserted deep enough below the. Surgical treatment of displaced olecranon fractures by tension band wiring technique. The incidence of olecranon fractures is 12 per 100.
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