Meta-analysis Of Tension-band Wiring Versus Plate Fixation For Olecranon Fracture

Objectives:To evaluate the clinical out-comes after tension-band wiring(TBW)and plate fixation(PF)for the treatmen of olecranon fracture(OF)by making a meta—analysis.Methods:By searching PubMed,Elsevier,Medline,Cochraner library,CBM,CNKI,Wan Fang Data and VIP,etc.And manual searching relevant journals,reference on tension-band wiring and plate fixation for the treatmen of olecranon fracture.Literature were selected according to inclusion and excluding criteria.Data were evaluated using RevMan5.3 for meta-analysis.The data included:Mayo Elbow Performance Score(MEPS),HSS elbow scoring,HSS elbow scoring excellent rate,modified MEPS,Disabilities of the arm,shoulder and hand(DASH),Brobery-Morrey elbow scoring,Brobery-Morrey elbow scoring excellent rate,operation time,blood loss,fracture healing time,complication rate,infection,implant loosening,heterotopic ossification,nonunion,ulnar neuritis.Results:13 studies involving 970 patients inclusion criteria.TBW group including 491 patients and PF group including 479 patients.The results of the meta—analyses showed no differences in the MEPS(P=0.17),MEPS excellent rate(P=0.29),Broberg-Morrey elbow scoring excellent rate(P=0.78),modified MEPS(P=0.40),HSS elbow scoring excellent rate(P=0.73),operation time(P=0.82),blood loss(P=0.16),fracture healing time(week,P=0.16),infection(P=0.62),nonunion(P=0.17),heterotopic ossificat-ion(P=0.77)and ulnar neuritis(P=0.63).The fracture healing time(month,P=0.04),HSS elbow scoring(P<0.00001)is lesser in the TBW group than in PF group(P=0.007),Broberg-Morrey scoring(P<0.00001),complication rate(P=0.02)and implant loosening(P<0.00001)is greater in the TBW group than in the PF group.Conclusion:In terms of surgical effectiveness,the PF was superior to the TBW in the DASH.To MEPS,Broberg-Morrey score excellent rate,HSS score excellentrate,modified MEPS,operation time,blood loss,fracture healing time(week),there were no significant differences in the two surgical methods.It was difficult to assess in the Broberg-Morrey score,HSS score and fracture healing time(month)in two surgical methods.In surgical safety,the postoperative complication rate and implant loosening of Kirschner wire were higher,but there was no significant difference between two group in postoperative infection,nonunion,heterotopic ossification and ulnar neuritis.In summary,both internal fixation methods are effective ways to treat olecranon fractures,but in the surgical effectiveness and safety of the PF is slightly better than the TBW.