A Danish perspective on the use of wearables for digital monitoring

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.

METHODS: This was a multicentre cohort study. Eligible patients were retrieved from the hospitals' administrative databases using diagnosis codes for elbow and olecranon fractures. The patients' 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.

RESULTS: 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.

CONCLUSIONS: 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.

FUNDING: None.

TRIAL REGISTRATION: Not relevant.