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.