We encountered a high incidence of complications related to the technique of tension-band wire fixation of displaced fractures of the olecranon in a five-year retrospective study of twenty patients (twenty fractures). All had been treated with primary open reduction using the AO technique of tension-band wiring. Twenty patients were followed at least to union as determined radiographically. The most frequent complication was symptomatic prominence of the Kirschner wires at the elbow in sixteen patients. There was skin breakdown in four patients, and infection developed in one. Measurable proximal migration of the Kirschner wires, however, occurred in only three patients. Prominence of the Kirschner wires usually was due to improper seating at the time of surgery (twelve of sixteen patients). Most complications that are related to this method of fixation may be avoided by careful attention to surgical technique.