Malpositioned olecranon fracture tension-band wiring results in proximal radioulnar synostosis

Eur J Med Res. 2015 Oct 29:20:87. doi: 10.1186/s40001-015-0184-7.


Background: Tension-band wiring (TBW) is a well-established fixation technique for two-part, transverse fracture types of the olecranon. However, complication rates up to 80 % are reported. By reporting on the enormous impact on the patient if failed the aim of the present report was to emphasize the importance of correct K wire positioning in TBW.

Case presentation: We present the case of a 49-year-old woman who suffered from a radioulnar synostosis of the forearm due to malpositioned K wires after TBW treatment. The patient was treated by heterotopic bone resection supported by ossification prophylaxis (radiotherapy and Indomethacin). At follow-up of 12 months after revision surgery, elbow motion was unrestricted with a strength grade 5/5. The patient was free of pain and reported no restrictions in daily as well as sporting activities. Radiologic assessment showed no recurrence of heterotopic bone tissue.

Conclusion: Intraoperative radiographic and clinical examination of the elbow is highly recommended to identify incorrect hardware positioning and, therefore, to avoid serious postoperative complications in TBW.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Fracture Fixation, Internal / adverse effects
  • Fracture Fixation, Internal / methods*
  • Humans
  • Middle Aged
  • Olecranon Process / injuries*
  • Olecranon Process / surgery
  • Postoperative Care
  • Preoperative Care
  • Radius / abnormalities*
  • Synostosis / etiology*
  • Ulna / abnormalities*
  • Ulna Fractures / surgery*

Supplementary concepts

  • Radioulnar Synostosis