Outcomes of an all-suture anchor technique for the treatment of transverse olecranon fractures: a case series

Abstract

Background: Mayo type IIa olecranon fractures are typically managed with plate osteosynthesis (PO) or tension band wire (TBW) fixation. Reoperation rates for the removal of prominent metalware are high following TBW. All-suture anchors (ASA) in a tension band configuration can potentially capitalise on tension band principles and reduce hardware irritation. This investigation aimed to review the outcomes of patients with Mayo IIa olecranon fractures managed with this technique.

Methods: This retrospective chart review describes the ASA surgical technique and assesses the outcomes of adult patients with Mayo IIa olecranon fractures managed with the technique between 1 August 2017 and 31 October 2021. Patient charts were used to capture basic demographic details, injury characteristics, timing of surgery and surgical outcomes. The outcomes of interest included the union rate, functional outcomes, complications and reoperation rates.

Results: Thirty patients met inclusion criteria; 60% were male, the majority of which (63%) were injured from a direct blow. Two injuries were compound. All but one fracture united, representing a union rate of 97%. The median postoperative total range of motion was 130°. The median Mayo Elbow Performance Score (MEPS) was 100 (excellent). Three cases complicated: two with superficial sepsis and exposed suture material, and one developed a fibrous non-union. No patients required reoperation.

Conclusion: The adult patients with transverse olecranon (Mayo type IIa) fractures managed with the described all-suture anchor technique in this investigation had a union rate of 97%, with excellent functional results as measured by the MEPS. No reoperations were required.

Level of evidence: 4