Biomechanical studies on transverse olecranon and patellar fractures: a systematic review with the development of a new scoring method Willeke A. Traa †§ , Pim J.A. Oomen †§ , Anniek den Hamer † , Maarten H.G. Heusinkveld † , and Nicola Maffulli ‡* † Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands, and ‡ Queen Mary University of London, Centre for Sports and Exercise Medicine, Mile End Hospital, Mann Ward, 275 Bancroft Road, London E1 4DG, UK Introduction: Several methods of transverse patellar and olecranon fixation have been described. This article compares biomechanical studies of various fixation methods using a newly developed scoring method. Source of data: The databases PubMed, Web of Science, Science Direct, Google Scholar and Google were searched for relevant studies. Areas of agreement: Fixation hardware failure remains a problem. Various materials and fixation techniques have been tested to provide an improved fixation of transverse olecranon and patellar fractures. Areas of controversy: The difference in biomechanical testing setup between the studies makes it hard to compare different fixation techniques. Growing points: The newly developed grading method was proved to be unbiased and reliable; however, extra specifications need to be added at some criteria when adopting the scoring method. Areas timely for developing research: Non-metallic constructs may provide an improvement to the currently used metallic tension band wiring technique; however, clinical research is required. Keywords: patellar fracture/olecranon fracture/internal fixation/tension band wiring Accepted: June 4, 2013 British Medical Bulletin 2013; 1–27 DOI:10.1093/bmb/ldt020 & The Author 2013. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com *Correspondence address. E-mail: n.maffulli@qmul. ac.uk § These authors contribu- ted equally to this work. British Medical Bulletin Advance Access published July 31, 2013 by guest on July 31, 2013 http://bmb.oxfordjournals.org/ Downloaded from