Abstract
The aim of this experiment is to compare the biomechanical strength of six distinct internal fixation techniques for Mayo type IIA olecranon fractures using biomechanical analysis. This study utilized tensile tests on artificial, shape-mimicking olecranon bones to assess their biomechanical properties. A tensile test was performed on the artificial, shape-mimicking olecranon bone at a 90° angle, with the tensile load applied at a rate of 2 mm/min until the test displacement reached 2 mm, at which point the test was halted. Throughout the test, the testing system was able to collect load and displacement data in real-time and simultaneously monitor the changes in the load-displacement relationship. The maximum loads for groups A-F were (75.34 ± 2.54), (85.53 ± 2.45), (106.57 ± 3.57), (115.21 ± 11.96), (92.76 ± 3.22), and (147.19 ± 4.29) N, respectively, and the stiffnesses were (33.46 ± 2.96), (39.29 ± 1.12), (51.07 ± 3.22), (53.76 ± 5.26), (40.99 ± 1.34), and (71.66 ± 1.77) N/mm, respectively. When the implantation depth of the Kirschner wires reached four times the standard deviation depth, its maximum load and stiffness performance were superior to those of the double cortical Kirschner wire tension band fixation.
Similar content being viewed by others
Data availability
The datasets generated and analysed during the current study are not publicly available due to the research project is still being further developed and deepened but are available from the corresponding author on reasonable request.
References
Cantore, M., Candela, V., Sessa, P., Giannicola, G. & Gumina, S. Epidemiology of isolated olecranon fractures: a detailed survey on a large sample of patients in a suburban area. JSES Int. 6, 309–314. https://doi.org/10.1016/j.jseint.2021.11.015 (2022).
den Hamer, A. et al. Current techniques for management of transverse displaced olecranon fractures. Muscles Ligaments Tendons J. 5, 129–140 (2015).
Baecher, N. & Edwards, S. Olecranon fractures. J. Hand Surg. Am. 38, 593–604. https://doi.org/10.1016/j.jhsa.2012.12.036 (2013).
Veillette, C. J. H. & Steinmann, S. P. Olecranon fractures. Orthop. Clin. North. Am. https://doi.org/10.1016/j.ocl.2008.01.002 (2008).
Chalidis, B. E., Sachinis, N. C., Samoladas, E. P., Dimitriou, C. G. & Pournaras, J. D. Is tension band wiring technique the gold standard for the treatment of olecranon fractures? A long term functional outcome study. J. Orthop. Surg, Res. 3, 9. https://doi.org/10.1186/1749-799X-3-9 (2008).
Powell, A. J., Farhan-Alanie, O. M. & McGraw, I. W. W. Tension band wiring versus locking plate fixation for simple, two-part Mayo 2A olecranon fractures: a comparison of post-operative outcomes, complications, reoperations and economics. Musculoskelet. Surg. 103, 155–160. https://doi.org/10.1007/s12306-018-0556-6 (2018).
Parker, J. R., Conroy, J. & Campbell, D. A. Anterior interosseus nerve injury following tension band wiring of the olecranon. Injury 36, 1252–1253 (2005).
Candal-Couto, J. J., Williams, J. R. & Sanderson, P. L. Impaired forearm rotation after tension-band-wiring fixation of olecranon fractures: evaluation of the transcortical K-wire technique. J. Orthop. Trauma. 19, 480–482 (2005).
Huang, T. W. et al. Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations. J. Trauma. 68, 173–176. https://doi.org/10.1097/TA.0b013e3181ad554c (2010).
Siebenlist, S., Buchholz, A. & Braun, K. F. Fractures of the proximal ulna: current concepts in surgical management. EFORT Open. Rev. 4, 1–9. https://doi.org/10.1302/2058-5241.4.180022 (2019).
Hewins, E. A. et al. Plate fixation of olecranon osteotomies. J. Orthop. Trauma. 21, 58–62 (2007).
Batihan, A. O., Maden, M., Ozdemir, M. & Kazimoglu, C. Is headless screw a valid alternative for the fixation of chevron olecranon osteotomy? A Biomechanical comparison of 4 fixation methods. J. Shoulder Elbow Surg. 34, 680–687. https://doi.org/10.1016/j.jse.2024.06.019 (2025).
Wang, K. Y. et al. Where should the pins be placed to decrease the failure rate after fixation of a Mayo IIA olecranon fracture? A Biomechanical analysis. Injury-International J. Care Injured 51, 1522–1526. https://doi.org/10.1016/j.injury.2020.04.018 (2020).
Lee, S. H. & Lee, Y. H. Ideal pin length and interval in tension band wiring using ring pins for transverse olecranon fractures: a biomechanical study. BMC Musculoskelet. Disord. https://doi.org/10.1186/s12891-025-08828-0 (2025).
Wilson, J., Bajwa, A., Kamath, V. & Rangan, A. Biomechanical comparison of interfragmentary compression in transverse fractures of the olecranon. J. Bone Joint Surg. Br. 93, 245–250. https://doi.org/10.1302/0301-620X.93B2.24613 (2011).
Di Francia, R. et al. Advantages of expulsion-proof pins in the treatment of olecranon fractures with tension band wiring: comparison with a control group. Orthop. Traumatol. Surg. Res. 105, 1593–1599. https://doi.org/10.1016/j.otsr.2019.08.020 (2019).
Gierer, P., Wichelhaus, A. & Rotter, R. [Fractures of the olecranon]. Oper. Orthop. Traumatol. 29, 107–114. https://doi.org/10.1007/s00064-017-0490-z (2017).
Brink, P. R. G. et al. Tension band wiring of the olecranon: is it really a dynamic principle of osteosynthesis? Injury 44, 518–522. https://doi.org/10.1016/j.injury.2012.08.052 (2012).
Villanueva, P., Osorio, F., Commessatti, M. & Sanchez-Sotelo, J. Tension-band wiring for olecranon fractures: analysis of risk factors for failure. J. Shoulder Elb. Surg. 15, 351–356 (2006).
Chan, K. W. & Donnelly, K. J. Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate? J. Orthop. 12, 111–117. https://doi.org/10.1016/j.jor.2014.04.018 (2014).
Yu, X. et al. Perforated Kirschner wire tension band in the treatment of Mayo IIA olecranon fractures. Front. Surg. https://doi.org/10.3389/fsurg.2024.1500317 (2024).
Kuwahara, Y. et al. Locked tension band wiring: A modified technique for olecranon Fractures-A multicenter study comparing clinical outcomes and complications with conventional methods. INDIAN J. Orthop. 57, 2024–2030. https://doi.org/10.1007/s43465-023-01017-y (2023).
Midtgaard, K. S. et al. Tension band wiring versus precontoured plate fixation for 2-Part and multifragmented olecranon fractures: A prospective randomized trial. J. Bone Joint Surg. Am. 107, 1907–1917. https://doi.org/10.2106/JBJS.24.01461 (2025).
Zhao, Y. et al. The effect of ding’s screws and tension band wiring for treatment of olecranon fractures: a Biomechanical study. Sci. Rep. 14, 9999. https://doi.org/10.1038/s41598-024-60264-7 (2024).
Steadman, J. N., Stephens, A. R., Zhang, C., Presson, A. P. & Kazmers, N. H. Cost assessment of plating versus tension band wiring constructs for treating Mayo type 2A olecranon fractures. J. Hand Surg. Am. 47, 311–319. https://doi.org/10.1016/j.jhsa.2021.12.009 (2022).
Tan, B. Y. J., Pereira, M. J., Ng, J. W. & Kwek, E. B. K. The ideal implant for Mayo 2A olecranon fractures? An economic evaluation. J. Shoulder Elb. Surg. 29, 2347–2352. https://doi.org/10.1016/j.jse.2020.05.035 (2020).
DelSole, E. M., Pean, C. A., Tejwani, N. C. & Egol, K. A. Outcome after olecranon fracture repair: does construct type matter? Eur. J. Orthop. Surg. Traumatol. 26, 153–159. https://doi.org/10.1007/s00590-015-1724-0 (2015).
van der Linden, S. C., van Kampen, A. & Jaarsma, R. L. K-wire position in tension-band wiring technique affects stability of wires and long-term outcome in surgical treatment of olecranon fractures. J. Shoulder Elb. Surg. 21, 405–411. https://doi.org/10.1016/j.jse.2011.07.022 (2011).
Funding
This work was supported by the following funding sources: Science and Technology Project of Yinzhou District (Project No: 2022AS062); Medical and Health Science and Technology Project of Zhejiang Province (Project No: 2020KY892); Ningbo Public Welfare Science and Technology Program Project (Project No: 2024S173); Ningbo Clinical Research Center for Orthopedics, Sports Medicine & Rehabilitation (Project No:2024L004). The funders had no role in study design, data collection/analysis, decision to publish, or preparation of the manuscript.
Author information
Authors and Affiliations
Contributions
Jun Zhang and Yuqin Fang.wrote the main manuscript text and Fude Jiao.Yang Gu.prepared Figs. 1, 2, 3, 4, 5, 6 and 7 and Yunqiang Zhuang.prepared Table 1, and 2. All authors reviewed the manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Below is the link to the electronic supplementary material.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.
About this article
Cite this article
Zhang, J., Fang, Y., Zhuang, Y. et al. Biomechanical study on different internal fixation methods for treating Mayo type IIA olecranon fractures of the ulna. Sci Rep (2026). https://doi.org/10.1038/s41598-026-35057-9
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-35057-9


