Objective To investigate the clinical effect of perforated kirschner wire tension band in the treatment of olecranon fractures in adults. Methods A retrospective casecontrol study was conducted on 56 adult patients with olecranon fractures admitted in Ningbo NO.6 Hospital from May 2013 to February 2017. The perforated Kirschner wire tension band fixation was used in Group A (n=24), while the common Kirschner wire tension band fixation was used in Group B (n=32). Group A was composed of 16 males and 8 females at age of (34.0±12.1)years, and  Group B was composed of 19 males and 13 females at age of (36.5±11.4)years. According to the Mayo classification, there were 7 patients with type I and 17 with type II in Group A, 15 with type I and 17 with type II in Group B. The operation time, bleeding volume, X transmission times, postoperative visual analogue score (VAS), fracture union time, loosening or failure of internal fixation, skin irritation and elbow joint function BrobergMorrey score were compared between the two groups. Results All patients were followed up for 1521 months (mean, 18 months). In Group A, the operation time, bleeding volume, Xray transmission times, fracture union time and skin irritation were (79.6±22.5)minutes,(111.3±26.2)ml, (7.2±2.2)times, (3.7±0.6)months, 1 case, respectively. In Group B, the operation time, intraoperative hemorrhage, transmission times, fracture healing time and skin irritation were (94.3±27.5)minutes, (152.0±31.4)ml, (11.0±3.4)times, (4.7±2.2)months, 9 cases, respectively. The difference between the two groups were all significant (P<0.05). There were no significant difference in VAS, failure of internal fixation and elbow function BrobergMorrey score between the two groups (P>0.05). Conclusions Compared with the anatomic plate, the perforated Kirschner wire tension band in the treatment of adult patients with olecranon fractures cannot only reduce the operation time and transmission times, reduce the intraoperative bleeding volume, but also shorten the fracture union time and avoid the occurrence of skin irritation and other complications.