67 patients with an acute isolated displaced fracture of the olecranon were included in this trial to compare tension band wire and plate fixation management techniques. The primary outcome was the Disabilities of the Arm, Shoulder, and Hand (DASH) score at 1 year. Secondary outcomes included surgeon reported measures, complications, pain, and cost. Both groups demonstrated a significant improvement in function from baseline values. There were no differences in DASH, surgeon reported outcomes, and cost between the two groups over the 1-year follow-up period. A significantly greater complication rate was observed in the tension band wire group due to a greater rate of metalwork removal.