We encountered a high incidence of complications related to the
technique of tension-band wire fixation of displaced fractures of the
olecranon in a five-year retrospective study of twenty patients (twenty
fractures). All had been treated with primary open reduction using the AO
technique of tension-band wiring. Twenty patients were followed at least to
union as determined radiographically. The most frequent complication was
symptomatic prominence of the Kirschner wires at the elbow in sixteen
patients. There was skin breakdown in four patients, and infection
developed in one. Measurable proximal migration of the Kirschner wires,
however, occurred in only three patients. Prominence of the Kirschner wires
usually was due to improper seating at the time of surgery (twelve of
sixteen patients). Most complications that are related to this method of
fixation may be avoided by careful attention to surgical technique.