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Biomechanical Comparison of Metal Versus Suture and Screw Tension Band Technique for Olecranon Fractures
Journal article   Peer reviewed

Biomechanical Comparison of Metal Versus Suture and Screw Tension Band Technique for Olecranon Fractures

David Kirby, Sorin Siegler, Mehrangiz Taheri, Luigi Piarulli, Harrison Fellheimer and Christopher Jones
The Journal of hand surgery (American ed.), Forthcoming
19 Jun 2026
DOI: https://doi.org/10.1016/j.jhsa.2026.04.016
PMID: 42322320

Abstract

tension band olecranon fracture suture tension band Olecranon fixation
Suture that approaches the strength of metal wire is now commonly used in many orthopedic applications. This study aimed to compare the strength of a suture and screw tension band fixation of olecranon fractures with the established method K-wire and metal tension band technique. A biomechanical model was created using 10 matched pair cadaver arms. A transverse olecranon osteotomy was made and repaired with either a standard 1.6-mm K-wire and 18-gauge metal tension-band construct or a tension band composed of two #2 ultra-high molecular weight polyethylene sutures combined with a 4.5-mm headless compression screw. Constructs were loaded through the triceps tendon and first subjected to cyclic loading to 300 N, followed by load-to-failure testing. Failure was defined as a fracture gap of 2 mm or more. During cyclic loading, 2 of 5 arms in the metal tension band group failed, whereas none in the suture/screw group did. The suture/screw construct was, on average, 219N stronger than the K-wire/metal tension band construct. The suture/screw olecranon tension band construct appears to be stronger than the commonly used metal tension band and should be considered as a suitable alternative for fixation of olecranon fractures.

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