Suture Tension Band Fixation of Olecranon Fractures: Description and Early Outcomes of a Novel Technique

ABSTRACT Background Mayo type IIa olecranon fractures requiring open reduction with internal fixation (ORIF) commonly undergo either locking plate fixation or wire tension band fixation. We describe a suture tension band (STB) technique utilizing Kirschner wires with eyelet holes, reporting on early surgical and postoperative functional outcomes. We hypothesize that this STB technique will demonstrate satisfactory pain, functional, and radiographic outcomes. Methods A retrospective review was conducted of all patients who underwent operative STB olecranon fracture fixation at a single institution between July 2017 and March 2024. Intraoperative data, patient reported outcome measures, and functional outcomes were collected. Radiographs taken at least 8 weeks postoperatively were interpreted by the senior author. Results In total, 16 patients underwent an ORIF with STB for isolated olecranon fractures. The average age of the patients was 61.78 years. Average surgery time was 68.29 minutes. At a mean follow-up of 15.5 ± 9.4 months, the median postoperative QuickDASH score was 6.8 (IQR: 0–25), and the median Mayo Elbow Performance Score was 85 (IQR: 85–100). Median VAS pain scores improved from 7 (IQR: 5–9) preoperatively to 0 (IQR: 0–2) postoperatively (p < 0.001), while median elbow subjective value improved from 0 (IQR: 0–0) to 90 (IQR: 70–99) (p < 0.001). Median postoperative elbow flexion on the affected side was 140° (IQR: 136.25°–147.5°), with full extension in most patients (median 0°, IQR: 0°–13.7°). Median pronation and supination were 87.5° (IQR: 80°–90°) and 82.5° (IQR: 70°–90°), respectively. Radiographs demonstrated fracture union in all patients. No complications or reoperations, including hardware removal, were observed. Conclusions Suture tension band fixation of olecranon fractures represents a low-profile, reproducible technique for treating olecranon fractures. There appears to be predictable healing rates of the fractures, without hardware irritation or need for hardware removal. Future studies will be needed to compare this technique to other traditional techniques for fixation of olecranon fractures.