Displaced Olecranon Fractures in Adults Clinical Evaluation

Murphy, Daniel F.; Greene, Walter B.; Dameron, Thomas B.

doi:10.1097/00003086-198711000-00029

Cited by 68 publications

(75 citation statements)

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“…On the contrary, the only patient who reported subjective difficulties caused by the migration of the osteosynthetic material had an intact bursa. The average time required for fracture healing was 9 (range [8][9][10][11][12][13][14] weeks, which is in accordance with the results reported in the literature. Oh and colleagues 22 reported an average healing time of 10 weeks for comminuted olecranon fractures.…”

Section: Resultssupporting

confidence: 87%

“…5 The most widely adopted method of tension band wiring achieves healing by transforming the posterior pulling force (created by the triceps muscle during contraction) into an anterior intra-articular interfragmentary compression on the joint surface. [6][7][8][9][10] The usual complications of this method are infections, delayed healing, fracture healing in an unfavourable position and, somewhat less frequently, ulnar nerve palsy. However, the most frequent complication is a migration of the Kirschner wires and subcutaneous protrusion of knots on the tension band wiring, which causes pain, weakened function, interruption in physical therapy and problems with the healing of the surgical wound.…”

Section: Resultsmentioning

confidence: 99%

“…The method of tension band wiring is the most frequently used method of surgical treatment in cases of olecranon fractures. [6][7][8][9][10][11] Despite maximal care, precision of surgical work and the expertise of the surgeon, up to 60% of patients experience varying degrees of migration and protrusion of the osteosynthetic material and associated pain, personal unease and slow rehabilitation with reduced mobility. 12,13 The second most frequently used operative technique is osteosynthesis with conventional plate and screws.…”

mentioning

confidence: 99%

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Tension plate for treatment of olecranon fractures: new surgical technique and case series study

Lukšić

Jurić

Boschi

et al. 2015

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Background: Our aim was to determine the effectiveness of a new surgical technique for olecranon fractures using a tension plate (TP) designed by the operating surgeon. Methods:We included patients with olecranon fractures treated between September 2010 and August 2013 in our study. Treatment involved a new implant and operative technique, which combined the most favourable characteristics of 2 frequently used methods, tension band wiring and plate osteosynthesis, while eliminating their shortcomings. The new method was based on the newly constructed implant.Results: Twenty patients participated in our study. We obtained the following functional results with our TP: median flexion 147.5° (interquartile range [IQR] 130°-155°), median extension 135°/deficit 10° (IQR 135°-145°), median pronation 90° (IQR 81.3°-90°), median supination 90° (IQR 80°-90°). Implant-related complications were noted in 1 patient, and implants were removed in 3 patients. The mean functional Mayo elbow performance score was 94.8 (range 65-100). The removal of the implant was considerably less frequent in patients operated using the new method and implant than in patients operated using conventional methods at our institution (p < 0.001). Mean duration of follow-up was 8 months. Conclusion:Our TP for the treatment of olecranon fractures is safe and effective. Functional results are very good, with significantly decreased postoperative inconveniences and need to remove the implant. Less osteosynthetic material was used for TP construction, but stability was preserved.

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Section: Resultssupporting

confidence: 87%

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

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Tension plate for treatment of olecranon fractures: new surgical technique and case series study

Lukšić

Jurić

Boschi

et al. 2015

cjs

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“…The common complications include migration of inserted K-wires, irritation symptoms due to a subcutaneous knot or bending sites of K-wires, and disruption of the fracture site. Among these complications, loosening and migration of K-wires can lead to loss of reduction and surprisingly many reports have pointed out this complication 4,5) . There have been various modifications of the technique to avoid loosening and migration of K-wires 2,9,10) .…”

Section: Discussionmentioning

confidence: 99%

Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results - Technical Note -

et al. 2013

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In order to investigate the feasibility of a modified tension band combined with anti-gliding loop augmentation technique for the treatment of comminuted patellar fracture, 21 patients with comminuted patellar fracture were enrolled in this study. After the modified tension band wiring of patellar fracture, a cerclage wire was passed around the patella. Anti-gliding loops were made on the bending sites of Kirshner-wires. A knot was tied using both ends of the anti-gliding loops, and the cerclage wire was tightened using proximal knots. Bone union was achieved at 4.5±1.5 months postoperatively without nonunion. The Lysholm score was 87.1±2.8, and the range of motion of the knee was 2. .5 o at the last follow-up. The modified tension band combined with anti-gliding loop augmentation technique might be considered an alternative modification of modified tension band wiring for the treatment of comminuted patellar fracture.

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“…However, a 76-95% good or excellent outcome of tension band wiring has been reported (Macko andSzabo 1985, Karlsson et al 2002). Still, one of the main problems of using tension band wiring is a rate of up to 80% of symptomatic hardware prominence (Murphy et al 1987, Romero et al 2000, Karlsson et al 2002, mostly resulting from local pressure or migration of the K-wires, and which requires a second operation to remove the hardware. To solve this problem, Larsen and Jensen (1991) tried modified Netz pins (Netz and Strömberg 1982) instead of K-wires in combination with tension banding and reported no case of backing-out, but finally had to remove the hardware in 70% of the patients.…”

Section: Discussionmentioning

confidence: 99%

The olecranon sled—a new device for fixation of fractures of the olecranon: A mechanical comparison of two fixation methods in cadaver elbows

2006

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Background Tension band wiring is the most common surgical procedure for fixation of fractures of the olecranon, but symptomatic hardware prominence and migration of K-wires can cause a high re-operation rate. The olecranon sled has been designed to minimize some of these problems.Material and methods Simulated olecranon fractures were created in 6 matched pairs of cadaver arms. Each pair was fixed with tension band wiring used on the one arm and the olecranon sled being used on the other. Mechanical testing was done with the humerus rigidly fixed in a vertical position while the forearm was held at 1 of 3 angles of elbow fixation, 45º, 90º and 135º, respectively. For each angle, the triceps and the brachialis muscles were sequentially loaded with 5 kg (50 N) for 20 cycles and the amount of fracture displacement measured.Results Loading of the brachialis muscle produced no increase in the fracture gap for either of the two fixation techniques. However, an increase in the fracture gap of up to 0.23 mm was found after cyclic loading of the triceps muscle for both techniques. The amount of increase was not significantly different between the two techniques.Interpretation The olecranon sled appears to provide as stable fixation as tension band wiring for olecranon fractures.

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Displaced Olecranon Fractures in Adults Clinical Evaluation

Cited by 68 publications

References 0 publications

Tension plate for treatment of olecranon fractures: new surgical technique and case series study

Tension plate for treatment of olecranon fractures: new surgical technique and case series study

Modified Tension Band Wiring Combined with Anti-Gliding Loop Augmentation Technique for the Treatment of Comminuted Patellar Fracture: Technical Note and Report of Early Results - Technical Note -

The olecranon sled—a new device for fixation of fractures of the olecranon: A mechanical comparison of two fixation methods in cadaver elbows

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