Tension band wiring for simple olecranon fractures: evaluation of surgical technique

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Tension band wiring for simple olecranon fractures: evaluation of surgical technique

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Title: Tension band wiring for simple olecranon fractures: evaluation of surgical technique
Author: Claessen, Femke M. A. P.; van den Bekerom, Michel P. J.; van Dijk, C. Niek; Carel Goslings, J.; Kerkhoffs, Gino M. M. J.; Doornberg, Job N.; Hoebink, E.; Nolte, P.; Eggen, P.; Blokzijl, R.; Haverkamp, D.; van Deurzen, D. L.; Vochteloo, A.; Kraal, T.; Peters, A.; Raven, E. E. J.; Campo, M. M.; Heijink, A.; Mutsaerts, E.; Tulner, S. A. F.; Lansdaal, J. R.; Jenner, J.; Jaspars, C. C. J.; van den Wijngaard, R. A.; Janus, A. J. M.; Nelissen, E. M.; van der Pluijm, M.; van der Bracht, H.; van Hove, R.; Broekhuis, D.; Somford, M. P.; Damen, P. J.; Scholten, P.; Wiegerinck, J. J.; Schonhuth, C.; van Kampen, D.; Eygendaal, D.; van Ooij, B.; Plaat, L.; Guitton, T. G.; Schouten, S. B.; Hermans, J.; Zwitser, E. W.; van der Wal, R. J. P.; Buijze, G. A.; van Tongel, A.; van Oostveen, D.; van de Velde, S.

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Citation: Claessen, F. M. A. P., M. P. J. van den Bekerom, C. N. van Dijk, J. Carel Goslings, G. M. M. J. Kerkhoffs, J. N. Doornberg, E. Hoebink, et al. 2017. “Tension band wiring for simple olecranon fractures: evaluation of surgical technique.” Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology 18 (3): 275-281. doi:10.1007/s10195-017-0450-2. http://dx.doi.org/10.1007/s10195-017-0450-2.
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Abstract: Background: In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. Materials and methods Forty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman’s rank correlation test. Results: None of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found. Conclusions: A rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment. Level of evidence Level IV diagnostic study.
Published Version: doi:10.1007/s10195-017-0450-2
Other Sources: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585090/pdf/
Terms of Use: This article is made available under the terms and conditions applicable to Other Posted Material, as set forth at http://nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of-use#LAA
Citable link to this page: http://nrs.harvard.edu/urn-3:HUL.InstRepos:34491860
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