Clinicoradiological Outcome of Double Screw Fixation Versus Tension Band Wiring After Olecranon Osteotomy in Complex Distal Humerus Fractures: A Prospective Randomized Study

Background: Complex distal humerus fractures (AO type 13-C) require olecranon osteotomy for adequate articular visualization. The optimal method for osteotomy fixation remains debated, with tension band wiring (TBW) being traditional but associated with hardware-related complications. Double screw fixation (DSF) offers a low-profile alternative with potentially fewer complications. Objective: To compare clinical and radiological outcomes of TBW versus DSF for olecranon osteotomy repair following surgical treatment of complex distal humerus fractures. Methods: This prospective randomized study included 60 patients (30 TBW, 30 DSF) with complex distal humerus fractures treated via olecranon osteotomy at SMS Medical College, Jaipur, from January 2024 to December 2024. Patients aged 15-60 years were followed at 01 week, 02 weeks, 01 month, and 03 months. Outcomes were assessed using Mayo Elbow Performance Score (MEPS), arc of motion, and complication rates. Results: Mean age was 41.00±12.59 years (TBW) and 42.50±11.03 years (DSF). Late postoperative complications occurred in 09 (30.00%) TBW patients versus 03 (10.00%) DSF patients (p