Shah FA, Sattar A, Iqbal J. Comparison of two fixation techniques of olecranon osteotomy after reconstruction of intra-articular distal humerus fractures. World J Orthop 2025; 16(12): 111460 [DOI: 10.5312/wjo.v16.i12.111460]
Corresponding Author of This Article
Aimal Sattar, Assistant Professor, Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar Pakistan, Street 1 Near Khyber Bazar, Peshawar 24100, Khyber Pakhtunkhwa, Pakistan. draimalsattar@gmail.com
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Orthopedics
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Retrospective Study
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Dec 18, 2025 (publication date) through Dec 17, 2025
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World Journal of Orthopedics
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2218-5836
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Shah FA, Sattar A, Iqbal J. Comparison of two fixation techniques of olecranon osteotomy after reconstruction of intra-articular distal humerus fractures. World J Orthop 2025; 16(12): 111460 [DOI: 10.5312/wjo.v16.i12.111460]
World J Orthop. Dec 18, 2025; 16(12): 111460 Published online Dec 18, 2025. doi: 10.5312/wjo.v16.i12.111460
Comparison of two fixation techniques of olecranon osteotomy after reconstruction of intra-articular distal humerus fractures
Faaiz Ali Shah, Aimal Sattar, Javed Iqbal
Faaiz Ali Shah, Aimal Sattar, Javed Iqbal, Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar Pakistan, Peshawar 24100, Khyber Pakhtunkhwa, Pakistan
Co-corresponding authors: Aimal Sattar and Javed Iqbal.
Author contributions: Shah FA contributed to the conception and design of study, data analysis and interpretation; Shah FA and Iqbal J contributed to data collection and they contributed equally to this manuscript as co-corresponding authors; Sattar A contributed to darting of manuscript and reviewing it for important intellectual content; Iqbal J contributed to approved the final version of study. All authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the Institutional Review Board Lady Reading Hospital (approval No. 145/LRH/MTI).
Informed consent statement: All the included subjects were contacted and requested for consent and for controlled up-to-date radiological and functional assessment in our Orthopaedic Out Patient Department.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at email address draimalsattar@gmail.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Aimal Sattar, Assistant Professor, Department of Orthopaedics and Traumatology, Lady Reading Hospital Peshawar Pakistan, Street 1 Near Khyber Bazar, Peshawar 24100, Khyber Pakhtunkhwa, Pakistan. draimalsattar@gmail.com
Received: July 1, 2025 Revised: August 7, 2025 Accepted: October 23, 2025 Published online: December 18, 2025 Processing time: 170 Days and 15.6 Hours
Abstract
BACKGROUND
Accurate surgical fixation of intra-articular distal humerus fractures require olecranon osteotomy. Repair of osteotomy is achieved with a variety of techniques but no consensus has been achieved regarding the optimum technique for fixing the olecranon osteotomy. In this retrospective study, we compared the functional and radiological outcome of the two commonly used techniques of fixing olecranon osteotomy after fixing distal humerus intra-articular fractures. We hypothesized that olecranon osteotomy fixed with 6.5 mm cancellous intramedullary screw alone yielded better radiological and functional outcome than fixation with cerclage wire over cancellous screw applied in figure of eight as tension band wiring (TBW).
AIM
To determine the radiological and functional outcome of olecranon osteotomy fixation with cancellous screw alone vs cancellous screw combined with cerclage wiring applied as TBW.
METHODS
This retrospective study was conducted in Lady Reading Hospital Peshawar Pakistan. Intra-articular distal humerus fractures fulfilling the inclusion criteria and operated during 2023 to 2025 were included. Olecranon osteotomy fixation with 6.5 mm cancellous screw alone was labelled as group A while cerclage wire over cancellous screw in figure of eight as TBW were labelled as group B. The demographics, radiological and functional outcome in both groups were compared at one year using Mayo Elbow Performance Score and Quick Disabilities of the Arm, Shoulder, and Hand Score.
RESULTS
We included 32 patients in this study. The mean age of group A patients was 34 ± 5.5 years while group B had a mean age of 34 ± 6.2 years. Radiological union of olecranon osteotomy was achieved in all cases in both groups. Functional outcome however was significantly better in group A than in group B (P < 0.05). The Mayo Elbow Performance Score was excellent in 14 (87.5%) and good in 2 (12.5%) patients in group A while 7 (43.47%) patients had excellent outcome, 5 (31.25%) good and 4 (25%) had fair outcome in group B. The mean Quick Disabilities of the Arm, Shoulder, and Hand Score was 24.5 ± 2.1 and 78.1 ± 12.1 in group A and B respectively (P < 0.05).
CONCLUSION
Similar radiological union was achieved in all patients of olecranon osteotomy treated with intramedullary screw alone and intramedullary screw with TBW. Functional outcome however was significantly better in intramedullary screw alone than in intramedullary screw with TBW.
Core Tip: In this retrospective study, we compared the radiological and functional outcomes of the two commonly used techniques for fixing olecranon osteotomy after fixing intra-articular distal humerus fractures. Fixation of olecranon osteotomy with intramedullary cancellous screw and washer yielded significantly better functional outcome and minimal complications than intramedullary screw and tension band wiring in young patients.
