A Comparative Study between Double Knot and Single Knot Tension Band Wire Techniques in Mayo Type IIA Olecranon Fracture.

Abstract

Olecranon fracture, common in upper extremity trauma, occurs due to a direct impact to the point of the elbow or a fall onto an outstretched hand. Being an intra-articular fracture, treatment is aimed to anatomic reduction, stable fixation and early mobilization. Tension band wiring (TBW) is a popular and widely practiced method using either single or double knot technique. But in our country single knot technique is commonly practiced. Aim of this study was to compare the clinical, radiological and functional outcome between double knot and single knot TBW techniques in Mayo type IIA olecranon fracture. This prospective observational study was conducted at NITOR, Dhaka, Bangladesh from January 2018 to December 2019. Patients with Mayo type IIA olecranon fractures were enrolled. Total 54 cases were included. Among them, 29 cases were treated with single knot (SK group) and 25 were treated with double knot (DK group). Both groups were compared by clinical and radiological outcome. Persistent mild pain and symptomatic hardware was significantly more among the SK group (p value 0.045 for both). No other significant inter group differences were found on overall incidence of complications (p value 0.0825), the arc of motion and MEPS. The final outcome of 49 cases, 25(51.02%) were excellent and remaining 24(48.98%) were good. Both procedures were safe in regard to overall complication rate. Double knot group had significantly more excellent results then single knot group (p value 0.022). It was concluded that, double knot TBW technique provides better outcome than single knot technique.