Tension Band Suturing Versus Tension Band Wiring for Management of Pediatric Olecranon Fractures: Systematic Review and Meta-analysis.

Abstract

Pediatric olecranon fractures require optimal fixation to prevent long-term morbidity. Tension band wiring (TBW) has been the gold standard, but tension band suturing (TBS) has emerged as a potential alternative. This study systematically reviews and compares outcomes of TBS and TBW in pediatric olecranon fractures. A systematic review and meta-analysis were conducted per Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Nine studies were included, with three directly comparing TBS to TBW. No statistically significant differences were found in pain, non-union, revision fixation, or extension loss (<i>P</i>>0.05). TBS demonstrated fewer hardware-related complications. TBS is a viable alternative to TBW, offering similar outcomes with reduced hardware complications. Further high-quality studies are needed. [<i>Orthopedics</i>. 2025;48(4):248-255.].