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Annals of African Surgery

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Tension band wiring fi xation is associated with good functional outcome after olecranon fractures at a Togo Hospital

A Anani, B Akouété, JE Yaovi, D Ekoué, W Atsi, D Assang

Abstract


Background: Tension band wiring (TBW) is a widely accepted technique for olecranon fractures. Various investigators have reported a significant rate of complications especially hardware prominence. The purpose of this study was to determine the clinical and radiological outcome after tension band wiring of olecranon fractures.
Methods: Sixty three patients (42 men and 21 women) were treated for fractures of the olecranon by TBW technique. Their mean age at the time of operation was 28 years (19 to 48). The mean follow-up period was 74.5 months (35 to 121). The overall outcome was evaluated using functional rating index described by Broberg and Morrey, the Visual Analogue Scale (VAS) subjective pain score (10 = unbearable pain) and patient satisfaction score (10 = complete satisfaction).
Results: Wound infection developed in six patients (09.5%). No nonunions, malunion or ulnar nerve palsies complicated the postoperative
period. Hardware removal was recorded in 45 patients (71.4%) due to pin prominence, localized pain or direct complaint. Removal was not  significantly affected by pin position (p = 0.201). Elbow pain persisted in 12 patients. Four patients (06.3%) had significantly reduced flexion arcs affecting the functional outcome. None of the patients had objective evidence of instability of the elbow. The mean range of elbow flexion, pronation and supination was 135°, 70° and 79° respectively. 29 patients (46%) had an excellent functional result while four (6.4%) had poor result. The poor results were signifi cantly associated with fracture type (p = 0.001) and the duration of immobilization (p = 0.003). The average  satisfaction rating was 9.1 out of 10 (range, 5–10).
Conclusion: Tension band wiring fixation for isolated olecranon fractures leads to good elbow function and minimal loss of physical capacity.



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