Surgical Management of Olecranon Fractures

This systematic review and meta-analysis evaluates surgical management strategies for olecranon fractures in adult patients, comparing tension-band wiring (TBW) with plate fixation (PF). The review included 24 studies, with 10 studies incorporated into the meta-analysis comparing TBW and PF.

Key Findings

Compared to TBW (n=270), patients undergoing PF (n=369) had significantly lower complication rates (RR, 0.48; 95% CI, 0.36-0.64; P<.01) and less hardware removal (RR, 0.36; 95% CI, 0.25-0.50; P<.01). Subgroup analyses showed no significant differences between randomized controlled trials and observational studies. Qualitative analysis identified novel fixation methods, including modified cable pin systems, tension banding through cannulated screws, olecranon memory connector fixation, and cancellous screw TBW.

Significance and Relevance

This meta-analysis suggests that plate fixation is associated with fewer complications and reduced need for hardware removal compared to tension-band wiring in olecranon fractures. Novel fixation methods may represent viable alternatives. For orthopedic surgeons specializing in upper extremity trauma, these findings provide evidence supporting the use of plate fixation to improve patient outcomes and reduce re-operation rates. The exploration of alternative fixation techniques offers insights into potential future advancements in olecranon fracture management.ShareExportRewrite