Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis
Background: The purpose of this study is to perform a systematic review of the literature comparing the utilization of tension-band wiring (TBW) and plate fixation for the surgical management of olecranon fractures. Methods: A systematic search of articles in PubMed and Embase databases was carried...
Saved in:
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | JSES Reviews, Reports, and Techniques |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666639125000239 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850086659340632064 |
|---|---|
| author | Mikhail A. Bethell, MS Tom R. Doyle, MB, MCh Eoghan T. Hurley, MB, MCh, PhD Harvey Allen, BS Tyler S. Pidgeon, MD Christian A. Péan, MD, MS Oke Anakwenze, MD, MBA Christopher S. Klifto, MD |
| author_facet | Mikhail A. Bethell, MS Tom R. Doyle, MB, MCh Eoghan T. Hurley, MB, MCh, PhD Harvey Allen, BS Tyler S. Pidgeon, MD Christian A. Péan, MD, MS Oke Anakwenze, MD, MBA Christopher S. Klifto, MD |
| author_sort | Mikhail A. Bethell, MS |
| collection | DOAJ |
| description | Background: The purpose of this study is to perform a systematic review of the literature comparing the utilization of tension-band wiring (TBW) and plate fixation for the surgical management of olecranon fractures. Methods: A systematic search of articles in PubMed and Embase databases was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing TBW to plate fixation for olecranon fractures were included. All statistical analyses were performed using Review Manager. A P value of < .05 was considered to be statistically significant. Results: Twenty studies with 2164 patients were included. There were no significant differences in the Disabilities of the Arm, Shoulder, and Hand score (12.3 ± 4.7 vs. 12.1 ± 4.9, P = .23), Mayo Elbow Performance score (92.0 ± 5.4 vs. 92.3 ± 3.7, P = .65), or overall range of motion (P = .15) between TBW and plate fixation. Although extension was statistically significant (7° ± 2° vs. 9° ± 2°, P = .05), the 2-degree difference is not clinically meaningful. There were significantly lower rates of loss of reduction (6.6% vs. 2.6%, P < .01), implant removal (31.4% vs. 14.3%, P < .01), overall reoperation (35.3% vs. 17.7%, P < .01), and complications (45.1% vs. 27.6%, P < .01) after plate fixation. Finally, there were no significant differences in wound breakdown (4.4% vs. 3.9%, P = .73) and infection rates (4.1% vs. 4.0%, P = .86). Conclusion: This study highlights that while TBW and plate fixation offer similar functional outcomes for olecranon fractures, plate fixation demonstrates superior results in terms of lower rates of fixation failure, implant removal, reoperation, and overall complications compared to TBW. These findings suggest that plate fixation should be preferred for surgical management for most patients. |
| format | Article |
| id | doaj-art-e4dbdbcf36944c988b40a86570e4f3ec |
| institution | DOAJ |
| issn | 2666-6391 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | JSES Reviews, Reports, and Techniques |
| spelling | doaj-art-e4dbdbcf36944c988b40a86570e4f3ec2025-08-20T02:43:25ZengElsevierJSES Reviews, Reports, and Techniques2666-63912025-08-015348749610.1016/j.xrrt.2024.12.016Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysisMikhail A. Bethell, MS0Tom R. Doyle, MB, MCh1Eoghan T. Hurley, MB, MCh, PhD2Harvey Allen, BS3Tyler S. Pidgeon, MD4Christian A. Péan, MD, MS5Oke Anakwenze, MD, MBA6Christopher S. Klifto, MD7Department of Orthopedic Surgery, Duke University, Durham, NC, USADepartment of Orthopedic Surgery, Duke University, Durham, NC, USA; Royal College of Surgeons in Ireland, Dublin, Ireland; Corresponding author: Tom R. Doyle, MB, MCh, Royal College of Surgeons in Ireland, Dublin, Ireland; Duke University School of Medicine, 40 Duke Medicine Circle, 124 Davison Building, Durham, NC 27710, USA.Department of Orthopedic Surgery, Duke University, Durham, NC, USADepartment of Orthopedic Surgery, Duke University, Durham, NC, USADepartment of Orthopedic Surgery, Duke University, Durham, NC, USADepartment of Orthopedic Surgery, Duke University, Durham, NC, USADepartment of Orthopedic Surgery, Duke University, Durham, NC, USADepartment of Orthopedic Surgery, Duke University, Durham, NC, USABackground: The purpose of this study is to perform a systematic review of the literature comparing the utilization of tension-band wiring (TBW) and plate fixation for the surgical management of olecranon fractures. Methods: A systematic search of articles in PubMed and Embase databases was carried out according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies comparing TBW to plate fixation for olecranon fractures were included. All statistical analyses were performed using Review Manager. A P value of < .05 was considered to be statistically significant. Results: Twenty studies with 2164 patients were included. There were no significant differences in the Disabilities of the Arm, Shoulder, and Hand score (12.3 ± 4.7 vs. 12.1 ± 4.9, P = .23), Mayo Elbow Performance score (92.0 ± 5.4 vs. 92.3 ± 3.7, P = .65), or overall range of motion (P = .15) between TBW and plate fixation. Although extension was statistically significant (7° ± 2° vs. 9° ± 2°, P = .05), the 2-degree difference is not clinically meaningful. There were significantly lower rates of loss of reduction (6.6% vs. 2.6%, P < .01), implant removal (31.4% vs. 14.3%, P < .01), overall reoperation (35.3% vs. 17.7%, P < .01), and complications (45.1% vs. 27.6%, P < .01) after plate fixation. Finally, there were no significant differences in wound breakdown (4.4% vs. 3.9%, P = .73) and infection rates (4.1% vs. 4.0%, P = .86). Conclusion: This study highlights that while TBW and plate fixation offer similar functional outcomes for olecranon fractures, plate fixation demonstrates superior results in terms of lower rates of fixation failure, implant removal, reoperation, and overall complications compared to TBW. These findings suggest that plate fixation should be preferred for surgical management for most patients.http://www.sciencedirect.com/science/article/pii/S2666639125000239OlecranonFractureTension band wiringPlate fixationSystematic reviewMeta-analysis |
| spellingShingle | Mikhail A. Bethell, MS Tom R. Doyle, MB, MCh Eoghan T. Hurley, MB, MCh, PhD Harvey Allen, BS Tyler S. Pidgeon, MD Christian A. Péan, MD, MS Oke Anakwenze, MD, MBA Christopher S. Klifto, MD Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis JSES Reviews, Reports, and Techniques Olecranon Fracture Tension band wiring Plate fixation Systematic review Meta-analysis |
| title | Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis |
| title_full | Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis |
| title_fullStr | Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis |
| title_full_unstemmed | Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis |
| title_short | Tension band wiring and plate fixation for Olecranon fractures: a systematic review and meta-analysis |
| title_sort | tension band wiring and plate fixation for olecranon fractures a systematic review and meta analysis |
| topic | Olecranon Fracture Tension band wiring Plate fixation Systematic review Meta-analysis |
| url | http://www.sciencedirect.com/science/article/pii/S2666639125000239 |
| work_keys_str_mv | AT mikhailabethellms tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT tomrdoylembmch tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT eoghanthurleymbmchphd tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT harveyallenbs tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT tylerspidgeonmd tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT christianapeanmdms tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT okeanakwenzemdmba tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis AT christopherskliftomd tensionbandwiringandplatefixationforolecranonfracturesasystematicreviewandmetaanalysis |