Repair of olecranon fractures using fiberWire without metallic implants: report of two cases

Abstract

Olecranon fractures are a common injury in fractures. The tension band technique for olecranon fractures yields good clinical outcomes; however, it is associated with significant complications. In many patients, implants irritate overlying soft tissues and cause pain. This is mostly due to protrusion of the proximal ends of the K-wires or by the twisted knots of the metal wire tension band. Below we described 2 cases of olecranon fractures treated with a unique technique using FiberWire without any metallic implants. Technically, the fragment was reduced, and two K-wires were inserted from the dorsal cortex of the distal segment to the tip of the olecranon. K-wire was exchanged for a suture retriever, and 2 strands of FiberWire were retrieved twice. Each of the two FiberWires was manually tensioned and knotted on the posterior surface of the olecranon. Bony unions could be achieved, and patients had no complaint of pain and skin irritation. There was only a small loss of flexion and extension in comparison with that of the contralateral side, and the patient did not feel inconvenienced in his daily life. Using the method described, difficulty due to K-wire or other metallic implants was avoided.

Figures

Figure 1

Radiographs and the intraoperative photograph of case 1. (A) Lateral radiograph of preoperative period. (B) The fracture site after fixation with 2 strands of FiberWire. Dis; distal. Rad; radial. (C) Lateral radiograph of intraoperative period. (D) Radiograph of 1 year postoperative period.

Figure 2

Surgical techniques using FiberWire. (A) Two K-wires were passed. HUM; Humerus. K-W; Kirshner wire. TRI; Triceps tendon. ULN; Ulna. (B) After resetting the segment, K-Wires were placed across the fracture site. (C) Two strands of FiberWire were retrieved with Suture-Retriever. FW; FiberWire. S-R; Suture Retriever. (D) Two sutures were knotted on the olecranon.

Figure 3

Radiographs of case 2. (A) Lateral radiograph of preoperative period. (B) Lateral radiograph of intraoperative period. (C) Radiograph of 1 year postoperative period.