Locked Tension Band Wiring: A Modified Technique for Olecranon Fractures-A Multicenter Study Comparing Clinical Outcomes and Complications with Conventional Methods.

Purpose: Tension band wiring is the standard treatment for olecranon fractures, but it is associated with high rate of implant-related complication. To reduce this high complication rate, we developed a modified technique, locked tension band wiring (LTBW). The aim of this study was to investigate whether LTBW reduces complication and reoperation rates compared to conventional methods (CTBW). Methods: We identified 213 olecranon fractures treated with tension band wiring: 183 were treated with CTBW, and 30 were treated with LTBW, and patients in each group were selected using propensity score matching. We evaluated operation time, intraoperative bleeding, complication and reoperation rates, the amount of Kirschner's wire (K-wire) back-out, and Mayo Elbow Performance Index (MEPI). Complications included nonunion, loss of fracture reduction, implant failure, infection, neurological impairment, heterotopic ossification, and implant irritation. Implant removal included at the patient's request with no symptoms. Results: We finally investigated 29 patients in both groups. The mean operation time was significantly longer in the LTBW (106.7 ± 17.5 vs. 79.7 ± 21.1 min; Conclusion: Our modified TBW significantly increased operation time compared to conventional method, but reduced the complication and removal rate and had equivalent functional outcomes in this retrospective study.