Use of Kirschner Wires With Eyelets for Tension Band Wiring of Olecranon Fractures

Abstract

Purpose To evaluate the clinical and radiographic outcomes of tension band wiring of displaced olecranon fractures treated using Kirschner wires with eyelets to assess their clinical performance with respect to complications such as backing out of the K-wires, restriction of forearm rotation, and neurovascular injury. Methods The authors retrospectively reviewed 44 patients treated for an isolated, displaced olecranon fracture and checked range of motion, postoperative pain, complications, and incidence of hardware removal. The mean follow-up period was 41 months (range, 26-73 mo). Results All fractures united, and anatomical reduction was achieved in all cases at final follow-up. Mean elbow flexion was 135 degrees (range, 115 degrees to 140 degrees), and mean elbow extension was 4 degrees (range, 0 degrees to 15 degrees). No pin migration, restriction of forearm rotation, or neurovascular injury occurred. Hardware removal was performed in 8 cases (18%). Compared to previous results with conventional Kirschner wires, no meaningful improvement in postoperative pain level or in the rate of hardware removal was observed. Conclusions Tension band wiring using the pin studied produced excellent clinical and radiologic outcomes for the treatment of isolated, displaced Mayo type IIA and some type JIB olecranon fractures. The pin was effective in preventing the backing out of Kirschner wires and avoiding the complications associated with anterior cortical engagement of Kirschner wires, such as neurovascular injury or restriction of forearm rotation. Copyright (C) 2013 by the American Society for Surgery of the Hand. All rights reserved. Type of study/level of evidence Therapeutic IV.