Schneider, Marco M., Nowak, Tobias E., Bastian, Leonard, Katthagen, Jan C., Isenberg, Joerg, Rommens, Pol M., Mueller, Lars P. and Burkhart, Klaus J. (2014). Tension band wiring in olecranon fractures: the myth of technical simplicity and osteosynthetical perfection. Int. Orthop., 38 (4). S. 847 - 856. NEW YORK: SPRINGER. ISSN 1432-5195

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Abstract

The tension band wiring (TBW) technique is a common treatment for the fixation of olecranon fractures with up to three fragments. The literature and surgeons describe TBW as an uncomplicated, always available and convenient operation producing excellent results. The purpose of this study was to determine whether TBW is more ambitious than believed or the procedure provides an increased level of tolerance concerning the surgical technique. This study reviewed 239 TBW cases in patients with olecranon fractures or osteotomies. We reviewed a total of 2,252 X-rays for ten operative imperfections: (1) nonparallel K-wires, (2) long K-wires, (3) K-wires extending radially outwards, (4) insufficient fixation of the proximal ends of the K-wires, (5) intramedullary K-wires, (6) perforation of the joint surface, (7) single wire knot, (8) jutting wire knot(s), (9) loose figure-of-eight configuration, and (10) incorrect repositioning. On average, there were 4.24 imperfections per intervention in the cases reviewed. A total of 1,014 of 2,390 possible imperfections were detected. The most frequent imperfections were insufficient fixation of the proximal ends of the K-wires (91 % of all cases), the use of a single wire knot (78 %) and nonparallel K-wires (72 %). Mayo IIa (n = 188) was the most common fracture type. Our results and the number of complications described by the literature together support the conclusion that TBW is not as easy as surgeons and the literature suggest. Although bone healing and the functional results of TBW are excellent in most cases, the challenges associated with this operation are underestimated. Level of Evidence: IV, treatment study.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Schneider, Marco M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Nowak, Tobias E.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bastian, LeonardUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Katthagen, Jan C.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Isenberg, JoergUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Rommens, Pol M.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Mueller, Lars P.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Burkhart, Klaus J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-441535
DOI: 10.1007/s00264-013-2208-7
Journal or Publication Title: Int. Orthop.
Volume: 38
Number: 4
Page Range: S. 847 - 856
Date: 2014
Publisher: SPRINGER
Place of Publication: NEW YORK
ISSN: 1432-5195
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
K-WIRE POSITION; DISPLACED FRACTURES; SURGICAL-TREATMENT; RISK-FACTORS; FIXATION; ELBOW; COMPLICATIONSMultiple languages
OrthopedicsMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/44153

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