Functional Assessment of Olecranon Fracture Management Using Tension Band Wiring and Locking Plate Osteosynthesis

Background: Olecranon fractures are frequently reported intra-articular fractures following elbow injuries. It requires stable fixation to restore joint congruity and mobilization. Traditionally, tension band wiring (TBW) was used for simple fractures. Locking plates are used for unstable fractures. The present study was done to determine the functional radiological and complication outcomes of olecranon fractures treated with tension band wiring versus locking plate osteosynthesis. Material and Methods: This prospective study was done on n=25 cases with displaced olecranon fractures of category (Mayo type IIA and IIB). N=13 cases were allotted to group A, treated with tension band wiring, and N=12 patients were allotted to Group B, and they were treated with locking plates. Patients were followed for six months. Outcome assessment was done by comparison of operative parameters, radiological union, range of motion, Mayo Elbow performance scores (MEPS), and complications. Results: The overall results of this study showed that the two groups were well-matched in terms of age, sex, injury mechanism, and fracture classification (Mayo IIA/IIB). Tension Band Wiring (TBW) had a significantly shorter operative time compared to Locking Plate fixation. Both techniques achieved a 100% union rate by 6 months. TBW showed a trend towards more complications like implant back-out (23.1%) and loss of reduction (15.4%). Conclusion: Both fixation methods provide satisfactory outcomes at 6 months follow-up. However, locking plate osteosynthesis may reduce implant-related complications and offer more consistent functional results.

Keywords: Olecranon fracture, Tension band wiring, Locking plate osteosynthesis, Mayo Elbow Performance Score.