Suture tape osteosynthesis for Mayo IIA olecranon fractures: A safe, effective alternative to metal implants

Background: Olecranon fractures are common upper-extremity injuries, and tension band wiring is the most frequently used fixation method for simple transverse fractures. Despite reliable fracture union, this technique is associated with a high rate of hardware-related complications and secondary surgical procedures. Objective: To describe a novel metal-free suture-based fixation technique for Mayo Type IIA olecranon fractures and to evaluate its clinical and functional outcomes. Methods: This study included twelve patients with displaced, non-comminuted Mayo Type IIA olecranon fractures treated using a high-strength suture tape osteosynthesis technique. The method uses FiberTape sutures passed through longitudinal transosseous tunnels and crossed posteriorly to replicate the biomechanical principles of tension band wiring without metallic implants. Patients were followed for six months. Clinical outcomes were assessed using the Mayo Elbow Performance Score (MEPS) and the Oxford Elbow Score (OES), while radiographic evaluation was performed to assess fracture healing. Results: Radiographic union was achieved in all patients by the eighth postoperative week. At final follow-up, 83% of patients regained full active range of motion. The mean MEPS was 97.5/100, and the mean OES was 47.33/48, indicating excellent functional outcomes. No post-operative complications, including infection, fixation failure, suture migration, or soft tissue irritation, were observed. Conclusion: The described metal-free suture tape fixation technique provides stable fracture fixation, excellent functional recovery, and eliminates hardware-related complications in the treatment of Mayo Type IIA olecranon fractures. This method represents a safe and effective alternative to traditional metallic fixation techniques.