Tension Band Wiring Vs Reconstruction Plate for the Treatment of Proximal Ulna and Olecranon Fractures

Title: Tension Band Wiring Vs Reconstruction Plate for the Treatment of Proximal Ulna and Olecranon Fractures

Authors: Dr H.S. Mann, Dr Girish Sahni, Dr Tajinder Bhalla

DOI: http://dx.doi.org/10.18535/jmscr/v4i9.60

Abstract

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Abstract

Aims: To clinically compare the result of tension band wiring technique for simple transverse fracture of olecranon and proximal ulna & plate fixation for comminuted fracture of olecranon and proximal ulna and to discuss the merits and demerits of each procedure.

Materials and Methods: 30 consecutive cases of the fracture of the olecranon or proximal ulna of skeletally mature patients of either sex, admitted in the Department of Orthopaedics, Rajindra Hospital and Government Medical College, Patiala were taken up for the study. Patients with Olecranon fractures were distributed alternative into two groups. Group A was managed by open reduction and internal fixation (ORIF) with tension band wiring (TBW), while group B was treated with ORIF with 3.5 mm reconstruction plate. All patients were assessed both clinically with measurement of flexion-extension and pronation- supination arcs and radiologically with elbow X-Rays. Functional outcome was estimated using the criteria laid by Weseley et al (1976), modified by Wolfgang et al (1987).

Results: Thirty patients (m: 20, f: 10) with a mean age of 43.7 years were operated. They were assessed at 12 weeks. Final result was Excellent in 20 patients (66.7%)., Good in 7 patients (23.3%) and Fair in 3 patients (10%).The fracture olecranon was more common with direct blow on posterior aspect of the elbow (46.7%) . Radiological union occurred in all the 30 cases with average union time 13.06 weeks in group A and 13.6 weeks in group B. The complications occured in 11 (36.7%) cases with group A reporting higher number of complications than group B.

Conclusion: Tension band wiring fixation remains the "gold standard" for the treatment of simple transverse fractures while reconstruction plate is more effective treatment option for improved outcome, earlier return to function and decreased rate of complications.

Keywords: olecranon, tension band, fracture, ulna, reconstruction plate, union.

References

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