New Perspective on the Tension-Band Wiring and Pin-And-Wire Systems in the Treatment of Displaced Olecranon Fractures

Purpose: Tension-band wiring is the mainstay for treating displaced olecranon fractures, which have thin soft-tissue coverage. Patients do not tolerate prominent ends of pins, and a migrating pin can easily penetrate the skin or cause irritation. We designed this nonrandomized, prospective study to analyze the performance of a new tension-band wiring system to treat olecranon fractures. Methods: Between March 1995 and February 1999, 60 patients with simple, displaced (＞2 mm) olecranon fractures without bone loss underwent surgery within 24 hours of injury by using the wiring system. This system had a one-piece pin and wire that preserve the spirit of the AO tension-band technique. Mayo elbow-performance scores were used to analyze subjective (pain, function) and objective (motion, stability) outcomes. Clinical complications and subjective feelings of prominence were also analyzed. Results: In no patient did the wire back out by more than 3 mm. Mean performance scores significantly increased from 30 before surgery to 86 after surgery. Twelve patients (20%) subjectively complained of pin prominence. In two patients, fixation was lost because of direct postoperative injury, and two had superficial wound infection, which substantially healed after appropriate debridement. When the distance between the pin-wire junction and bone was within 5 mm, patients' subjective feeling of prominence was significantly decreased (p＜0.05, Pearson χ^2) Conclusion: This new system was effective in the treatment of olecranon fractures. We encountered no complications of skin penetration, nonunion, pseudarthrosis, the wire backing up, or deep wound infections with this system.

並列關鍵字

pin with wire system ； tension band wiring ； Kirschner wire ； cerclage wire ； olecranon fracture

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