{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T15:09:32Z","timestamp":1773932972835,"version":"3.50.1"},"reference-count":20,"publisher":"Danish Medical Association","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Dan Med J"],"abstract":"<jats:p>INTRODUCTION. Tension band wiring (TBW) is one of the most commonly used methods of fixation for displaced olecranon fractures. This study aimed to assess whether implant positioning (IMPO) of TBW for olecranon fractures was associated with complications.\n\nMETHODS. This was a multicentre cohort study. Eligible patients were retrieved from the hospitals\u2019 administrative databases using diagnosis codes for elbow and olecranon fractures. The patients\u2019 healthcare files were reviewed for demographics and complications. A major complication was defined as any reoperation within eight weeks or deep infection. Any loss of fixation was added to define surgical complications. Preoperative X-rays were classified according to the Mayo classification. Post-operative X-rays were evaluated, and the IMPO of TBW was rated on a 0-10 scale, yielding 10 points if all conditions were met. A high IMPO score was 9-10 points, a low score was eight points or less.\n\nRESULTS. A total of 307 patients were included: 76% with Mayo type 2A and 20% with type 2B. The TBWs were rated with a median score of eight points (range: 3-10), and 11.8% had major complications. There was a 5% complication rate with a high IMPO score, compared with 15% with a low score (p = 0.010). A total of 105 patients (34%) had surgical complications: 21% with a high IMPO score and 44% with a low IMPO score.\n\nCONCLUSIONS. The IMPO score after TBW for olecranon fractures has a clear correlation with post-operative complications. We propose that at least nine out of ten points should be achieved before surgery is acceptable.\n\nFUNDING. None.\n\nTRIAL REGISTRATION. Not relevant.<\/jats:p>","DOI":"10.61409\/a05250445","type":"journal-article","created":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T08:53:09Z","timestamp":1771923189000},"page":"1-8","source":"Crossref","is-referenced-by-count":0,"title":["An implant positioning score for tension band wiring in olecranon fractures"],"prefix":"10.61409","author":[{"given":"Kia Cirke M\u00f8ller","family":"Hansen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefan","family":"Jensen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bjarke","family":"Viberg","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"40208","published-online":{"date-parts":[[2026,2]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","unstructured":"Karlsson M, Hasserius R, Karlsson C, et al. Fractures of the olecranon: a 15- to 25-year followup of 73 patients. Clin Orthop Relat Res. 2002;403:205-212. https:\/\/doi.org\/10.1097\/00003086-200210000-00030","DOI":"10.1097\/00003086-200210000-00030"},{"key":"ref1","doi-asserted-by":"publisher","unstructured":"Matar HE, Ali AA, Buckley S, et al. Surgical interventions for treating fractures of the olecranon in adults. Cochrane Database Syst Rev. 2014;11:CD010144. https:\/\/doi.org\/10.1002\/14651858.CD010144.pub2","DOI":"10.1002\/14651858.CD010144.pub2"},{"key":"ref2","doi-asserted-by":"publisher","unstructured":"Duckworth AD, Clement ND, Aitken SA, et al. The epidemiology of fractures of the proximal ulna. Injury. 2012;43(3):343-346. https:\/\/doi.org\/10.1016\/j.injury.2011.10.017","DOI":"10.1016\/j.injury.2011.10.017"},{"key":"ref3","unstructured":"Weber BG, Vasey H. Osteosynthesis in olecranon fractures. 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J Orthop Surg Res. 2008;3:9. https:\/\/doi.org\/10.1186\/1749-799X-3-9","DOI":"10.1186\/1749-799X-3-9"},{"key":"ref7","doi-asserted-by":"publisher","unstructured":"Rommens PM, K\u00fcchle R, Schneider RU, Reuter M. Olecranon fractures in adults: factors influencing outcome. Injury. 2004;35(11):1149-1157. https:\/\/doi.org\/10.1016\/j.injury.2003.12.002","DOI":"10.1016\/j.injury.2003.12.002"},{"key":"ref8","doi-asserted-by":"publisher","unstructured":"Schneider M, Nowak T, Bastian L, et al. Tension band wiring in olecranon fractures: the myth of technical simplicity and osteosynthetical perfection. Int Orthop. 2014;38(4):847-855. https:\/\/doi.org\/10.1007\/s00264-013-2208-7","DOI":"10.1007\/s00264-013-2208-7"},{"key":"ref9","doi-asserted-by":"publisher","unstructured":"Villanueva P, Osorio F, Commessatti M, Sanchez-Sotelo J. Tension-band wiring for olecranon fractures: analysis of risk factors for failure. J Shoulder Elbow Surg. 2006;15(3):351-356 https:\/\/doi.org\/10.1016\/j.jse.2005.08.002","DOI":"10.1016\/j.jse.2005.08.002"},{"key":"ref10","doi-asserted-by":"publisher","unstructured":"Claessen FMAP, van den Bekerom MPJ, van Dijk CN, et al. Tension band wiring for simple olecranon fractures: evaluation of surgical technique. J Orthop Traumatol. 2017;18(3):275-281. https:\/\/doi.org\/10.1007\/s10195-017-0450-2","DOI":"10.1007\/s10195-017-0450-2"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"175","DOI":"10.2106\/00004623-199502000-00019","article-title":"Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid","volume":"44","author":"Morrey","year":"1995","unstructured":"Morrey BF. Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid. Instr Course Lect. 1995;44:175-185","journal-title":"Instr Course Lect"},{"key":"ref12","doi-asserted-by":"publisher","unstructured":"Koldaas MIB, Pedersen JN, H\u00f8jsager FD, et al. Implant positioning (IMPO) in undisplaced femoral neck fractures: association to reoperation and development of an IMPO scoring system. Injury. 2020;51(2):372-379. https:\/\/doi.org\/ 10.1016\/j.injury.2019.12.003","DOI":"10.1016\/j.injury.2019.12.003"},{"key":"ref13","doi-asserted-by":"publisher","unstructured":"Baumgaertner MR, Curtin SL, Lindskog DM, Keggi JM. The value of the tip-apex distance in predicting failure of fixation of peritrochanteric fractures of the hip. J Bone Joint Surg Am. 1995;77(7):1058-1064. https:\/\/doi.org\/10.2106\/00004623-199507000-00012","DOI":"10.2106\/00004623-199507000-00012"},{"key":"ref14","doi-asserted-by":"publisher","unstructured":"Tosounidis TH, Castillo R, Kanakaris NK, Giannoudis PV. Common complications in hip fracture surgery: tips\/tricks and solutions to avoid them. Injury. 2015;46 (suppl 5):S3-S11. https:\/\/doi.org\/10.1016\/j.injury.2015.08.006","DOI":"10.1016\/j.injury.2015.08.006"},{"key":"ref15","doi-asserted-by":"publisher","unstructured":"von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370(9596):1453-1457. https:\/\/doi.org\/10.1016\/S0140-6736(07)61602-X","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"ref16","unstructured":"Kontur. Region Syddanmark, 2020. https:\/\/regionsyddanmark.dk\/media\/2ghei5vb\/syddanmark_ok.pdf"},{"key":"ref17","unstructured":"Ministry of Health. Healthcare in Denmark. An overview. Copenhagen: Ministry of Health, 2017:4-20. https:\/\/www.ism.dk\/Media\/C\/A\/Healthcare-in%20denmark%20an%20overview%20english-V16-dec.pdf"},{"key":"ref18","doi-asserted-by":"publisher","unstructured":"Kuza CM, Matsushima K, Mack WJ, et al. The role of the American Society of anesthesiologists physical status classification in predicting trauma mortality and outcomes. Am J Surg. 2019;218(6):1143-1151. https:\/\/doi.org\/10.1016\/j.amjsurg.2019.09.019","DOI":"10.1016\/j.amjsurg.2019.09.019"},{"key":"ref19","doi-asserted-by":"publisher","unstructured":"Bethell MA, Doyle TR, Hurley ET, et al. Tension band wiring and plate fixation for olecranon fractures: a systematic review and meta-analysis. 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