Comparison Of Functional And Radiological Outcomes Of Olecranon Fractures Treated With Tension Band Wiring With Kirschner Wires To Transcortical Screw Fixation-A Randomised Controlled Study

Aim: To compare the clinical and radiological outcomes of fixation of olecranon fractures by a transcortical screw with conventional tension band wiring (TBW) using a Kirschner wire (K-wire).Material and methods: This is a non-blinded randomised controlled trial comprising two groups (n = 30 each) with Mayo type A olecranon fractures fixed with either TBW or transcortical cancellous screws (CCS). Outcomes included the Mayo elbow performance index (MEPI), time to union, range of motion (ROM), and rates of complication among these two groups.Results: Most of the patients showed excellent scoring as per MEPI in both the groups at 6 weeks (90% in TBW group and 76.7% in CCS group) and were not significant (p = 0.719). Signs of the radiological union were noted in 80% of the cases at 6 weeks and complete at 6 months. Hardware-related complications(83% symptomatic hardware and 6.7% implant back-out), infect ion, and mean ROM were similar between the two groups (elbow flexion was 142.33 +/- 24.67 degrees in TBW group and 143.1 +/- 10.19 degrees in transcortical screw group, p = 0.246) at the end of the study.Conclusion:There were no statistically significant differences in the clinical-radiological outcomes and complications fixing the non-comminuted olecranon fractures with either transcortical screw or TBW.Clinical significance:Transcortical screw fixation is an acceptable alternative to TBW for non-comminuted olecranon fractures in terms of union and functional outcome.