Olecranon fractures: An old fixation device for a new surgical technique

Introduction: Internal fixation in not-comminuted oblique and transverse olecranon fractures is commonly performed with tension band wiring. However, despite its high healing rate, this technique is associated with a high rate of complications, often requiring the removal of fixation devices in up to 80 % of cases. The aim of our study was to describe a surgical technique using eyelet pins that maintains the effectiveness of the classic tension band wiring while reducing intolerance or displacement of the fixation devices. Methods: Fifteen patients with surgically treated Mayo type II A or II B olecranon fractures, meeting the inclusion criteria, were enrolled. Clinical and functional assessments were conducted using MEPS and DASH scores at the 12 month follow-up. Additionally, complications and the duration of the operation were documented. Results: Fifteen patients were enrolled, with eight having type II A and seven having type II B olecranon fractures. The mean patient age was 46.8 years, including ten males and five females. Nine cases involved the right side, while six involved the left. At the 12-month follow-up, the mean MEPS score was 98/100, and the DASH score was 9. Two patients (13.3 %) experienced superficial wound infections, and two (13.3 %) had persistent pain at the triceps tendon insertion site. No cases required removal of fixation devices. Conclusion: The eyelet pin system was found to be a safe and effective method for reducing and fixing olecranon fractures. Based on a limited series, this new technique exhibits the same reliability and reproducibility as tension band wiring but with a lower rate of complications.