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Objectives and questions: Tension band wiring and proximal ulnar plate fixation are commonly used fixation methods for olecranon fractures. However, they may not be suitable for repairing proximal olecranon avulsion fractures. In this study, we present a novel fixation technique – the “Anchor-Salvage Technique” – for the treatment of proximal avulsion fractures.

Material and methods: 27 patients treated with the “Anchor-Salvage Technique” were included. A contoured 2.7 mm T-shaped plate served as an “Anchor”. The plate’s longitudinal arm was passed retrograde through a medial opening at the triceps tendon insertion, while the transverse arm was secured at the bony bare area of the olecranon tip. Distal traction was applied to the olecranon tip and triceps tendon, the reduction was achieved through a process analogous to “Salvage”. The parameters followed were fracture healing time, elbow range of motion(ROM), related functional scores (the Mayo score and the DASH score), and complications related to internal fixation.

Results: The average follow-up period was 20 months and fractureshad healed in all patients included in the study, with an average fracture union of 9.5 weeks. No patient reported fixation failure, serious infection, or revision surgery. The average ROM of the elbow joint was 125°. The Mayo score was excellent in 20patients and good in 7. The average DASH score was 15.

Discussion and conclusions: The “Anchor-Salvage Technique”, specifically designed for olecranon avulsion fractures, is based on a novel fixation principle that provides stable fixation, allows for early functional exercise, and leads to good final functional outcomes.