The With Or Without Olecranon K-wire Trial Comparing Tension Band Wire Fixation and Cerclage Fixation in Displaced Stable Olecranon Fractures

What this Trial Is About

Researchers are investigating treatments for stable but displaced fractures of the elbow tip (olecranon), specifically Mayo type 2a and 2b fractures. The study compares two surgical methods: tension band wiring (TBW), which uses pins and metal wire, and cerclage fixation (CF), which uses metal wire alone. Previous studies suggest CF may result in fewer re-operations and complications than TBW, so this trial aims to test that hypothesis in a randomized controlled setting. Participants will be randomly assigned to receive either cerclage fixation or tension band wiring surgery. Both procedures involve surgical open reduction and internal fixation of the fracture, with cerclage using two 1.0mm wires and TBW using a 1.0mm wire plus two 1.6mm k-wires. The study will follow 200 patients for 36 months after surgery, with follow-up visits at 2 weeks, 6 weeks, 3 months, 12 months, and 36 months. These visits include physiotherapist assessments and a radiograph at 6 months. During the study, researchers will monitor re-operation rates, complications, patient-reported outcomes using tools like Quick-DASH and SMFA scores, pain levels, elbow motion range, grip strength, and time to return to work. Physiotherapists conducting assessments will not know which surgery was performed. Operation details such as surgery time and radiation exposure will also be recorded. This comprehensive follow-up aims to provide clear results on the benefits and risks of each surgical method.

The With Or Without Olecranon K-wires Trial