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Tension band wiring for simple olecranon fractures : evaluation of surgical technique

Femke MAP Claessen, Michel PJ van den Bekerom, C Niek van Dijk, J Carel Goslings, Gino MMJ Kerkhoffs, Job N Doornberg, on behalf of the Shouldere elbow platform, HANS VAN DER BRACHT UGent and Alexander Van Tongel UGent (2017) JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY. 18(3). p.275-281
abstract
In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. Forty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman's rank correlation test. None of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found. A rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment. Level IV diagnostic study.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
Elbow trauma, Olecranon fracture, Tension band, Technique pain, Disability, MEASUREMENT INFORMATION-SYSTEM, UPPER-EXTREMITY DISABILITY, COMPUTED-TOMOGRAPHY, RADIAL HEAD, CLASSIFICATION, RELIABILITY, LIGAMENT
journal title
JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
J. Orthop. Traumatol.
volume
18
issue
3
pages
275 - 281
ISSN
1590-9921
1590-9999
DOI
10.1007/s10195-017-0450-2
language
English
UGent publication?
yes
classification
A2
copyright statement
I have retained and own the full copyright for this publication
id
8514933
handle
http://hdl.handle.net/1854/LU-8514933
date created
2017-03-20 15:56:03
date last changed
2017-11-20 10:26:21
@article{8514933,
  abstract     = {In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. 
Forty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman's rank correlation test. 
None of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found. 
A rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment. 
Level IV diagnostic study.},
  author       = {Claessen, Femke MAP and van den Bekerom, Michel PJ and van Dijk, C Niek and Goslings, J Carel and Kerkhoffs, Gino MMJ and Doornberg, Job N and Shouldere elbow platform, on behalf of the and VAN DER BRACHT, HANS and Van Tongel, Alexander},
  issn         = {1590-9921},
  journal      = {JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY},
  keyword      = {Elbow trauma,Olecranon fracture,Tension band,Technique pain,Disability,MEASUREMENT INFORMATION-SYSTEM,UPPER-EXTREMITY DISABILITY,COMPUTED-TOMOGRAPHY,RADIAL HEAD,CLASSIFICATION,RELIABILITY,LIGAMENT},
  language     = {eng},
  number       = {3},
  pages        = {275--281},
  title        = {Tension band wiring for simple olecranon fractures : evaluation of surgical technique},
  url          = {http://dx.doi.org/10.1007/s10195-017-0450-2},
  volume       = {18},
  year         = {2017},
}

Chicago
Claessen, Femke MAP, Michel PJ van den Bekerom, C Niek van Dijk, J Carel Goslings, Gino MMJ Kerkhoffs, Job N Doornberg, on behalf of the Shouldere elbow platform, HANS VAN DER BRACHT, and Alexander Van Tongel. 2017. “Tension Band Wiring for Simple Olecranon Fractures : Evaluation of Surgical Technique.” Journal of Orthopaedics and Traumatology 18 (3): 275–281.
APA
Claessen, F. M., van den Bekerom, M. P., van Dijk, C. N., Goslings, J. C., Kerkhoffs, G. M., Doornberg, J. N., Shouldere elbow platform, on behalf of the, et al. (2017). Tension band wiring for simple olecranon fractures : evaluation of surgical technique. JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY, 18(3), 275–281.
Vancouver
1.
Claessen FM, van den Bekerom MP, van Dijk CN, Goslings JC, Kerkhoffs GM, Doornberg JN, et al. Tension band wiring for simple olecranon fractures : evaluation of surgical technique. JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY. 2017;18(3):275–81.
MLA
Claessen, Femke MAP, Michel PJ van den Bekerom, C Niek van Dijk, et al. “Tension Band Wiring for Simple Olecranon Fractures : Evaluation of Surgical Technique.” JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY 18.3 (2017): 275–281. Print.