Augmented intramedullary screw tension band construct for olecranon fracture reduction and fixation: a review of literature and surgical technique

Joseph T Labrum 4th; Brock D Foster; Douglas R Weikert

doi:10.1016/j.jseint.2020.04.005

Augmented intramedullary screw tension band construct for olecranon fracture reduction and fixation: a review of literature and surgical technique

JSES Int. 2020 Jun 17;4(3):470-477. doi: 10.1016/j.jseint.2020.04.005. eCollection 2020 Sep.

Authors

Joseph T Labrum 4th¹, Brock D Foster², Douglas R Weikert³

Affiliations

¹ Department of Orthopaedic Surgery, Vanderbilt Medical Center, Nashville, TN, USA.
² Department of Orthopaedic Surgery, Wenatchee Valley Hospital, Wenatchee, WA, USA.
³ Hand and Microvascular Surgery, Department of Orthopaedic Surgery, Vanderbilt Medical Center, Nashville, TN, USA.

Abstract

Olecranon fractures, which make up 10% of upper extremity fractures in adults, often require anatomic reduction and stable internal fixation. Successful olecranon fracture osteosynthesis has classically been achieved via tension band wiring or plate fixation. This article reviews the indications, outcomes, and a surgical technique as an alternative construct for tension band wiring of olecranon fractures. The technique involves placement of an ulnar intramedullary partially threaded screw that is used as a proximal point of attachment for tension band wiring of the olecranon. Although infrequently used by orthopedic surgeons, this construct has been shown to be biomechanically and clinically superior to classic Kirschner wire tension banding techniques. This review is intended to familiarize surgeons with a surgical technique that can be applied to a variety of proximal ulna fractures.

Keywords: Olecranon fracture; intramedullary; lag screw; tension band wiring; trauma; upper extremity.