Biomechanical Comparison of Metal Versus Suture and Screw Tension Band Technique for Olecranon Fractures.

PURPOSE: Suture that approaches the strength of metal wire is now commonly used in many orthopedic applications. This study aimed to compare the strength of a suture and screw tension band fixation of olecranon fractures with the established method K-wire and metal tension band technique.

METHODS: A biomechanical model was created using 10 matched pair cadaver arms. A transverse olecranon osteotomy was made and repaired with either a standard 1.6-mm K-wire and 18-gauge metal tension-band construct or a tension band composed of two #2 ultra-high molecular weight polyethylene sutures combined with a 4.5-mm headless compression screw. Constructs were loaded through the triceps tendon and first subjected to cyclic loading to 300 N, followed by load-to-failure testing. Failure was defined as a fracture gap of 2 mm or more.

RESULTS: During cyclic loading, 2 of 5 arms in the metal tension band group failed, whereas none in the suture/screw group did. The suture/screw construct was, on average, 219N stronger than the K-wire/metal tension band construct.

CONCLUSIONS: The suture/screw olecranon tension band construct appears to be stronger than the commonly used metal tension band and should be considered as a suitable alternative for fixation of olecranon fractures.