Tension band wiring through double-cannulated screws as a new internal fixation method for treatment of olecranon fractures: a randomized comparative study.

Abstract

The aim of this study was to assess the therapeutic effects and complications of tension band wiring (TBW) through the use of double-cannulated screws versus conventional TBW in the treatment of olecranon fractures. Eligible participants were randomly assigned to 2 groups to undergo different methods of fixation. The related indices and data of the 2 groups were collected for comparative analysis after an average follow-up of 32.7±6.6 months. Average fracture healing time was 11.4 weeks in the double-screw TBW group and 12.6±1.8 weeks in the conventional TBW group (p=0.000). There was significant difference in complications related to fixation between the 2 groups. In the double-screw TBW group (42 patients), 2 patients felt screw head prominence with no pain and requested no further intervention; in contrast, 21 patients experienced complications associated with internal fixation in the conventional TBW group. Mean Mayo Elbow Performance Score (MEPS) score was 87.90±6.0 in the double-screw TBW group, compared to 83.67±6.6 in the conventional TBW group at 24-month follow-up (p=0.002). The rate of elbow function in the double-screw TBW group (29/42, 69.05%) was higher than that of the conventional TBW group (16/46, 34.78%) (p=0.000). In comparison with conventional TBW, TBW with double-cannulated screws can significantly reduce complications, lower reoperation rate, improve elbow function, shorten healing time, as well as diminish surgical trauma.