• Tobenna J Oputa, Ricci Plastow, James Kennedy, Neil Jain, and North West Olecranon Fracture Study Group.
• Trauma and Orthopaedics, Health Education North West, Manchester, M1 3BN, UK. Tobi@doctors.org.uk.
• Arch Orthop Trauma Surg. 2022 Nov 1; 142 (11): 3341-3345.

IntroductionTension band wire (TBW) and locking plate fixation (LPF) are widely used fixation methods for displaced fractures of the olecranon. The aim of our study was to review the current operative management of olecranon fractures and compare the complication and re-operation rates for patients undergoing TBW and LPF.Materials And MethodsRetrospective data were collected for all patients who underwent acute fixation of olecranon fractures in 2016 across nine hospitals in the United Kingdom. We reviewed these cases to determine the incidence of complications and re-operations.ResultsOne hundred and forty patients were included in the study. Seventy-three (52%) had TBW, 67 (48%) had LPF. Males were more likely to have LPF (p = 0.01) as were patients with comminuted fractures (p < 0.01). The overall complication rate was 25%, including an infection rate of 3%, a prominent metalwork irritation rate of 12% and the overall re-operation rate was 17%. There was no significant difference in the complication rate (p = 0.38), infection rate (p = 0.92) or rate of prominent metalwork irritation (p = 0.10) between patients undergoing TBW and LPF. Sub group analysis of patients with comminuted fractures also demonstrated no significant difference in complication rates (p = 0.75) or re-operation rates (p = 0.26).ConclusionLPF has previously been advocated to be advantageous to TBW due to lower reported complication and re-operation rates despite there being no significant difference in functional outcomes. In this multicentre case series, which is the largest in the literature to date, we did not observe any significant differences in complication rates or re-operation rates between the two, even amongst comminuted fractures (which are traditionally treated with LPF), when decision making was left to surgeon preference. We, therefore, recommend that choice of fixation method should be left to individual surgeon's preference.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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