{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T14:27:10Z","timestamp":1787754430726,"version":"build-2784847793"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\n Purpose:<\/jats:title>\n The purpose of this study was to systematically review the literature to assess surgical complications following surgical management of olecranon fractures.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A literature search of MEDLINE, Embase, and the Cochrane Library was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies reporting complications following olecranon fracture management were included. The complication profile of plate fixation (PF), screw fixation, and tension band wiring (TBW) was recorded. Implant removal rates were considered independent of complication rates.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Eighty-six studies were included in the analysis, with 5,161 patients who underwent an olecranon fracture treatment with an average age of 50.2 years (range, 7.4-88.8) and an average follow-up of 30.8 months (range, 3-218). The majority of studies used PF (58.1%). Screw fixation had higher implant complications than PF (5.9% vs 3.0%, p < 0.001), and PF had the highest percentage of musculoskeletal complications (3.6%, p <0.001) and wound complications (4.8%, p = 0.048). Nerve complications were similar among the 3 surgical options (p = 0.233). PF had the lowest complication rate (12.6%, p < 0.001), while screw fixation had the lowest reoperation (8.6%, p < 0.001) and implant removal rates (6.2%, p < 0.001). The overall complication rate for TBW was 18.4%, with loss of reduction being the most common complications occurring in 2.8% of patients.<\/jats:p>\n <\/jats:sec>\n \n Conclusion:<\/jats:title>\n PF demonstrated lower overall complications compared with screw fixation, with increased rates of symptomatic implants requiring removal which contributed to higher reoperation rates. TBW demonstrated an inferior complication profile compared with both modern fixation options. Further research should expand on the limited comparative studies between screw and PF.<\/jats:p>\n <\/jats:sec>\n \n Level of Evidence:<\/jats:title>\n \n Therapeutic\n Level III<\/jats:underline>\n . See Instructions for Authors for a complete description of levels of evidence.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.2106\/jbjs.rvw.24.00163","type":"journal-article","created":{"date-parts":[[2025,3,28]],"date-time":"2025-03-28T08:47:10Z","timestamp":1743151630000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Complications Associated with Surgical Management of Olecranon Fractures"],"prefix":"10.2106","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2270-9067","authenticated-orcid":false,"given":"Mikhail A.","family":"Bethell","sequence":"first","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7696-2981","authenticated-orcid":false,"given":"Eoghan T.","family":"Hurley","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6946-4634","authenticated-orcid":false,"given":"Harvey","family":"Allen","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0949-9269","authenticated-orcid":false,"given":"Jay M.","family":"Levin","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8046-2085","authenticated-orcid":false,"given":"Christopher S.","family":"Klifto","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0990-3383","authenticated-orcid":false,"given":"Oke","family":"Anakwenze","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4391-5708","authenticated-orcid":false,"given":"Malcolm R.","family":"DeBaun","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7445-1152","authenticated-orcid":false,"given":"Christian A.","family":"P\u00e9an","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine, Durham, North Carolina"},{"name":"Department of Orthopedic Surgery, Duke University, Durham, North Carolina"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2025,3]]},"reference":[{"issue":"11","key":"r1-20250325","doi-asserted-by":"crossref","first-page":"1149","DOI":"10.1016\/j.injury.2003.12.002","article-title":"Olecranon fractures in adults: factors influencing 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A clinical and radiographic comparison of tension band wiring and plate fixation","volume":"285","author":"Hume","year":"1992","journal-title":"Clin Orthop Relat Res"},{"issue":"8","key":"r15-20250325","doi-asserted-by":"crossref","first-page":"1711","DOI":"10.1007\/s00264-014-2378-y","article-title":"Olecranon fractures: factors influencing re-operation","volume":"38","author":"Snoddy","year":"2014","journal-title":"Int Orthop"},{"issue":"8","key":"r16-20250325","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1007\/s00402-014-2021-9","article-title":"Simple and comminuted displaced olecranon fractures: a clinical comparison between tension band wiring and plate fixation techniques","volume":"134","author":"Tarallo","year":"2014","journal-title":"Arch Orthop Trauma Surg"},{"issue":"15","key":"r17-20250325","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.2106\/JBJS.16.00773","article-title":"Plate versus tension-band wire fixation for olecranon fractures: a prospective randomized trial","volume":"99","author":"Duckworth","year":"2017","journal-title":"J Bone Joint Surg Am"},{"key":"r18-20250325","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/1749-799X-3-9","article-title":"Is tension band wiring technique the \u201cgold standard\u201d for the treatment of olecranon fractures? A long term functional outcome study","volume":"3","author":"Chalidis","year":"2008","journal-title":"J Orthop Surg Res"},{"issue":"1","key":"r19-20250325","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1016\/0020-1383(87)90386-X","article-title":"The complications of surgical treatment of displaced fractures of the olecranon","volume":"18","author":"Helm","year":"1987","journal-title":"Injury"},{"key":"r20-20250325","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1186\/s13018-016-0465-z","article-title":"Efficacy and safety of tension band wiring versus plate fixation in olecranon fractures: a systematic review and meta-analysis","volume":"11","author":"Ren","year":"2016","journal-title":"J Orthop Surg Res"},{"issue":"10","key":"r21-20250325","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.2106\/JBJS.H.01419","article-title":"Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures","volume":"91","author":"Buijze","year":"2009","journal-title":"J Bone Joint Surg Am"},{"issue":"9","key":"r22-20250325","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1097\/BOT.0b013e318239273c","article-title":"Biomechanical evaluation of suture-augmented locking plate fixation for proximal third fractures of the olecranon","volume":"26","author":"Wild","year":"2012","journal-title":"J Orthop Trauma"},{"issue":"5","key":"r23-20250325","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1097\/BOT.0b013e3181f22465","article-title":"Comparison of olecranon plate fixation in osteoporotic bone: do current technologies and designs make a difference?","volume":"25","author":"Edwards","year":"2011","journal-title":"J Orthop Trauma"},{"issue":"6","key":"r24-20250325","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/BOT.0000000000001139","article-title":"What is the ideal starting point for an olecranon screw? An anatomic cadaveric study","volume":"32","author":"Potter","year":"2018","journal-title":"J Orthop Trauma"},{"issue":"1","key":"r25-20250325","doi-asserted-by":"crossref","first-page":"e24","DOI":"10.1097\/BOT.0000000000002145","article-title":"Intramedullary screw fixation of olecranon fractures Reduces the risk of early unplanned reoperation: a retrospective review of 556 patients","volume":"36","author":"Meals","year":"2022","journal-title":"J Orthop Trauma"},{"issue":"3","key":"r26-20250325","doi-asserted-by":"crossref","first-page":"131","DOI":"10.5005\/jp-journals-10080-1510","article-title":"Comparison of functional and radiological outcomes of olecranon fractures treated with tension band wiring with Kirschner wires to transcortical screw fixation: a randomised controlled study","volume":"15","author":"Sinha","year":"2020","journal-title":"Strateg Trauma Limb Reconstr"},{"issue":"1","key":"r27-20250325","doi-asserted-by":"crossref","first-page":"95.e1","DOI":"10.1016\/j.jhsa.2023.05.001","article-title":"Evaluation of intramedullary olecranon screw fixation for simple olecranon fractures: a biomechanical study","volume":"50","author":"McKnight","year":"2025","journal-title":"J Hand Surg Am"},{"issue":"4","key":"r28-20250325","first-page":"252","article-title":"A technique for low-profile intramedullary fixation of intraarticular proximal ulnar fractures","volume":"17","author":"Rodriguez","year":"2008","journal-title":"J Surg Orthop Adv"},{"issue":"7","key":"r29-20250325","first-page":"E211","article-title":"Comparison of outcomes and costs of tension-band and locking-plate osteosynthesis in transverse olecranon fractures: a matched-cohort study","volume":"44","author":"Amini","year":"2015","journal-title":"Am J Orthop (Belle Mead NJ)"},{"issue":"11","key":"r30-20250325","doi-asserted-by":"crossref","first-page":"1995","DOI":"10.1016\/j.jse.2017.07.017","article-title":"Societal costs in displaced transverse olecranon fractures: using decision analysis tools to find the most cost-effective strategy between tension band wiring and locked plating","volume":"26","author":"Francis","year":"2017","journal-title":"J Shoulder Elbow Surg"}],"container-title":["JBJS Reviews"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.24.00163","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:27:24Z","timestamp":1787750844000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.2106\/JBJS.RVW.24.00163"}},"subtitle":["A Systematic Review"],"short-title":[],"issued":{"date-parts":[[2025,3]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2106\/jbjs.rvw.24.00163","relation":{},"ISSN":["2329-9185"],"issn-type":[{"value":"2329-9185","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3]]}}}