OTA 2008 Posters

Scientific Poster #124 Upper Extremity OTA-2008

The Use of Fiberwire Suture for Fixation of Olecranon Fractures: A Biomechanical Comparison of Various Fixation Techniques

William M. Hakeos, MD1 (b-Arthrex, Smith and Nephew); Christopher Wybo, MS1 (n);
Major Shane A. Knighton, PhD2 (n); Paul J. Dougherty, MD3 (n); Soheil Najibi, MD, PhD1 (n);
1Department of Orthopaedic Surgery, Henry Ford Health System, Detroit, Michigan, USA;
2Air Force Institute of Technology, Dayton, Ohio, USA;
3Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, Michigan, USA

Purpose: Surgical fixation of the olecranon is a common procedure used in the setting of acute fracture or olecranon osteotomy for surgical exposure. While the tension band wire technique has traditionally been the standard of care, this procedure is known to have a high complication rate, often necessitating additional surgeries for removal of hardware. Various methods of fixation have been reported in the literature. This study was performed to explore the strength of fixation of three distinct constructs.

Methods: 23 cadaveric arms (10 matched pairs plus 3 single specimens; 7 males, average age 78.7 years; 5 females, average age 69.6 years) were dissected free of all soft tissue attachments with the exception of the triceps tendon insertion and the elbow capsule. A transverse olecranon fracture was created in the midportion of the semilunar notch using a sagittal saw. The specimens were then fixed in one of three methods: a single intramedullary screw (IMS, 7 specimens), an intramedullary screw with a 16-gauge stainless steel wire tension band (S+W, 8 specimens), or an intramedullary screw with a No. 2 Fiberwire suture tension band (S+F, 10 specimens). The elbows were then mounted on an Instron machine where load to failure was measured. Failure was defined as 2 mm of displacement at the fracture site and was measured with an extensometer. All elbows were loaded to failure at a rate of 1 mm/sec.

Results: The mean load to failure of the IMS group was 893 ± 781 N. The mean load to failure of the S+W group was 1686 ± 404 N, while the S+F group averaged 1599 ± 682 N.

Conclusion and Significance: No significant difference was found in the load to failure between the S+W and S+F groups (P = 0.346). Analysis of variance determined a statistically significant difference between the IMS and S+F or S+W groups (P = 0.0495). The use of either a standard tension band wire or a Fiberwire suture conferred additional stability to the intramedullary screw construct. We concluded that fixation of olecranon fractures with an intramedullary screw and either a stainless steel wire or a Fiberwire suture creates a construct of similar strength.

If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.

• The FDA has not cleared this drug and/or medical device for the use described in this presentation   (i.e., the drug or medical device is being discussed for an “off label” use).  ◆FDA information not available at time of printing. Δ OTA Grant.