BACKGROUND: Despite the good results that are usually reported after fixation at the sites of olecranon @entity174 and osteotomies, problems such as loss of fixation, nonunion, and the need for revision surgery are still encountered. Various types of fixation have been recommended, but few have been evaluated with use of clinically relevant cyclic load testing at appropriate levels of stress. The purpose of the present study was to test multiple olecranon fixation techniques under physiologic cyclic loads. METHODS: We studied ten cadaveric elbows with use of cyclic loading that simulated (1) active range of motion and (2) pushing up from a chair. Each specimen underwent fixation of a simulated 50% transverse @entity174 with use of intramedullary and cortically fixed @entity1055 (in randomized order) followed by fixation with a 7.3-mm-diameter cancellous screw with and without a @entity2701 band. Displacement transducers were placed posteriorly on the @entity2701 side and anteriorly near the articular surface. RESULTS: Both configurations involving the 7.3-mm-diameter cancellous screw provided the most stable fixation-nearly five times better than that provided by the Kirschner-wire techniques. Use of the @entity2701 band in conjunction with the intramedullary screw improved the stability of fixation. In none of the constructs did the AO @entity2701 band result in compression across the osteotomy gap. CONCLUSIONS AND CLINICAL RELEVANCE: The use of a 7.3-mm screw in conjunction with a @entity2701 band provided better fixation of simulated displaced transverse @entity174 than did the use of Kirschner wires in conjunction with a @entity2701 band or the use of a screw only. The AO principle of converting posterior tensile forces to articular compressive forces was not demonstrated in this study. We therefore question the validity of the @entity2701 band concept in @entity174 and recommend passive rather than active range of motion in the immediate postoperative period to limit @entity174 distraction.

Cyclic loading of XXXX constructs.

@entity2701 :: ('MESH:D018781', 'Disease') :: ['tension'] @entity1055 :: ('MESH:D000381', 'Disease') :: ['tension band constructs'] @entity174 :: ('MESH:D050723', 'Disease') :: ['fractures', 'olecranon fracture', 'olecranon fracture fixation', 'fracture']
@entity174 :: (MESH:D050723,Disease) :: ['olecranon fracture fixation']
