validity of tension band wring in treatment of olecranon compound fractures

ABSTRACT

Compound fracture olecranon alone or associated other injuries is different type of war injuries. Different methods of treatment used in its management. In this study I assess the validity of using tension band wiring and intramedullary K-wires in treatment of such fractures and comparing this result with other studies. Of the study is to assess the validity of this technique in the management of compound fracture olecranon. Non-Randomized clinical trial [NRCT]done in Al-Kindy teaching hospital and Al-Jarah private hospital in the period between Jan, 2001 and Dec.2006. Two hundred twelve patients visited these hospitals. A 96 patients were selected according to certain criteria [type B ASIF classification and type 1 and 2 Gustillo classification]. We divided those patients into two groups, group A 62 patients with isolated compound fractures olecranon, and group B 32 patients with neglected fractures treated in other hospitals either they treat them without fixation or they were dealt with other injuries and leave the olecranon fracture later on. Those patients visited these hospitals within 4-6 weeks. Male to female ratio was 3.77 for the sample [group A and B]. In group A; the highest age group was 20-29 year [48.4%].The rate of union was 61.3% healed within the first three months. The range of motion was 61.3% got full range of motion and 3.23% developed loss of extension 15-20 degrees. The incidence of infection was 11.3% and mostly superficial. Follow up for two years. In group B, the male to female ratio was 7.51 also the highest age group was 20 -29 year [44.1%]. The rate of union was 8.8% during the first three months while 38.2% within 6-9 months and 26.5%within 9-12 months. The incidence of infection was 8.82%.Gaining full range of motion 5.9% while loss of extension 10-15 degrees was 26/5% and loss of more than 20 degrees was 11.8%. Follow up for two years. Tension band wiring and intramedullary K-wires proved to be the ideal method of fixation of compound fracture olecranon as early as possible in order to get rapid union and excellent range of motion