Tension Band Wiring for Olecranon Fractures: Relative Stability of Kirschner Wires in Various Configurations

Background: To assess clinical and functional outcomes as well as the relative stability of various Configurations of tension band wiring approaches for treating olecranon fractures, a retrospective cohort study was conducted. Methods: Seventy-seven consecutive adult patients with 78 olecranon fractures were treated using tension hand wiring techniques in three different configurations. The configurations differed in the location of the ends of Kirschner wires with the following locations being used: in the proximal ulnar canal, through the anterior ulnar cortex, and in the distal ulnar canal. Results: Based on average follow-tip of 2.76 years (range, 1.1-5.5 years), all three techniques achieved high union rates and low complication rates. However, the Kirschner wires in the first technique allowed proximal pin migration with elbow irritation as compared with the second and the third techniques (p = 0.001, 0.03, respectively). Conclusions: Placement of the ends of Kirschner wires in the proximal ulnar canal should be avoided whenever possible. Because placement of the ends of Kirschner wires through the anterior ulnar cortex may produce serious complications as reported in medical literature, placement of the ends of Kirschner wires in the distal Ulnar canal may be the most effective approach.