Evaluating the Utility of the Lateral Elbow Radiograph in Central Articular Olecranon Reduction: An Anatomic and Radiographic Study

Kubik, Jeremy F.; Schneider, Prism; Buckley, Richard; Korley, Robert; Duffy, Paul; Martin, Ryan

doi:10.1097/bot.0000000000001037

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…In other reports, inflammatory and immunemediated etiology has been suggested as the cause of primary DJD in cats (14), and immune dysfunction has been seen in association with DJD in a genomic/proteomic study (15). Some studies have reported the pathology of feline arthritis (16,17), and it is gradually being elucidated. To further our understanding of the pathophysiology of feline DJD, it is necessary to prove these relationships precisely (18).…”

Section: Discussionmentioning

confidence: 98%

“…In general, orthogonal radiography has been recommended for use when diagnosing orthopedic lesions, and only appendicular and vertebral joints were assessed by orthogonal radiography in the present study. Although evaluation of the precise internal joint structure is difficult based on a single-plane radiograph (17), the utility of the single radiograph for evaluation of joint incongruity has been reported (29) in a human study. Appendicular OA, especially the hip and stifle joints, probably requires two radiographic views for diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Retrospective Radiographic Study of Degenerative Joint Disease in Cats: Prevalence Based on Orthogonal Radiographs

Kimura

Okada

et al. 2020

Front. Vet. Sci.

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Feline degenerative joint disease (DJD) has been reported worldwide. Radiographic evidence, including that from single-plane radiographs, has been used for diagnosis in these reports, though orthogonal radiographs are generally required to diagnose DJD. However, more orthogonal radiographs are required for diagnosis. In this study, we investigated how many orthogonal radiographs are necessary to diagnose feline DJD among domestic short-haired cats. We analyzed the data from 101 cats for which the owners requested screening for arthritis. Orthogonal radiographs of appendicular and intervertebral joints were taken from the chest to the caudal side. Radiographs were then reviewed and graded by severity of DJD in each joint. Radiographic evidence of appendicular DJD was detected in 74.26% of 101 cats, of which 40.59% had intervertebral DJD (typically of the lumbosacral joint). Appendicular DJD was most common in elbow joints. Lameness was recognized by an owner of two cats and was diagnosed by a veterinarian in two cats. No obvious pain was detected on palpation in any cats with appendicular osteoarthritis, but lumbosacral DJD was associated with back pain in seven cases. Aging was associated with radiographic evidence of DJD: radiographic evidence of DJD was observed in most older domestic short-haired cats. Most cases without lumbosacral DJD had no obvious symptoms. As the lifespan of cats increases due to better lifestyles, diet, and medical treatment, lumbosacral DJD, which is more likely in older cats, may become an increasingly important clinical problem. In addition, orthogonal radiograph must be taken to make diagnosis for appendicular joint DJD especially hip and stifle joint.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Retrospective Radiographic Study of Degenerative Joint Disease in Cats: Prevalence Based on Orthogonal Radiographs

Kimura

Okada

et al. 2020

Front. Vet. Sci.

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“…In addition, the quality of fracture reduction was evaluated with plain radiographs which may not as accurate as the CT scan. 20,35 Although some of the data of suture fixation in comminuted olecranon fracture were published previously, 12,17 our study presented the different technique in fixation of the articular portion and outer surface. Furthermore, this study is the first to focus on quality of reduction from suture fixation in olecranon fracture.…”

Section: Discussionmentioning

confidence: 84%

Triple suture fixation for displaced comminuted olecranon fracture with a stable ulnohumeral joint

Luenam,

Kosiyatrakul

2023

J Orthop Surg (Hong Kong)

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Purpose To report the outcome of a novel fixation technique using three high-strength sutures which is including articular buttress suture, cerclage suture, and tension band with off-loading triceps suture (triple suture fixation) in the treatment of displaced comminuted olecranon fracture with a stable ulnohumeral joint (Mayo type IIB). The rationale of using this technique is that the sutures have been used to stabilize multiple fracture fragments in all sides of the olecranon. Material and Methods Between July 2018 and July 2021, 10 patients (7 women, 3 men; mean age, 49.9 years; mean follow-up duration, 27.8 months) with Mayo type IIB olecranon fractures who underwent triple suture fixation were included in the study. The elbow was immobilized in a splint for 2 weeks postoperatively. Range-of-motion exercises were initiated after splint removal and weight bearing was allowed at 6 weeks postoperatively. Results Average active range of motion of the elbow was 145° of flexion (range, 135°–150°), 6.5° of extension (range, 0°–30°), 83° of supination (range, 70°–85°), and 77.5° of pronation (range, 70°–80°). Mean MEPS was 98.3 (range, 85–100) and DASH score was 3.1 (range, 0–10) at the final follow-up. Radiographic data at the final follow-up analyzed by paired t test demonstrated that there was no statistically significant difference of proximal olecranon height (OH), trochlear notch width (TW), and OH/TW ratio between postoperative treatment and normal side ( p-value >.05). No complication of implant prominence, fixation failure, nonunion, infection or heterotopic ossification was found postoperatively. Breakage of drill bit occurred during drilling a distal oblique hole for articular buttress suture in one patient. Conclusion The triple suture fixation is an effective treatment with low incidence of complications in treatment of Mayo type IIB olecranon fractures. Larger comparative studies are needed to confirm the value of such technique.

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“…For example, malreduction was previously identified on lateral elbow radiographs only 73% of the time, with interrater reliability of 0.28 to 0.66. 22 Furthermore, 86% of fractures categorized as simple on lateral radiograph were identified as comminuted on CT. 6 Inconsistency in preoperative radiograph quality can complicate this issue, especially when patients are splinted or otherwise immobilized. CT would likely increase sensitivity and agreement in identifying articular impaction.…”

Section: Discussionmentioning

confidence: 99%

Incidence and Management of Articular Impaction in Geriatric Olecranon Fractures

Wadhwa

Goodnough

Finlay

et al. 2021

J Am Acad Orthop Surg

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Introduction: Olecranon fractures are common in the elderly. Articular impaction is encountered occasionally, but the incidence and outcomes after treatment of this injury pattern have not been well characterized. Methods: We evaluated a cohort of geriatric olecranon fractures to determine the incidence of articular impaction and describe a technique for open reduction and internal fixation. Results: Of the 63 patients in our series, 31 had associated intraarticular impaction (49.2%). Patients with articular impaction did not have significantly different rates of postoperative complications (11/31, 35.5% versus 10/31, 32.3%; P = 1.00) or revision surgery (10/31, 32.3% versus 8/31, 25.8%; P = 0.780) compared with those without articular impaction. Conclusion: Articular impaction is a common feature of geriatric olecranon fractures. Surgeons must maintain a high index of suspicion and have a surgical plan in place for managing this component of the injury.

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Evaluating the Utility of the Lateral Elbow Radiograph in Central Articular Olecranon Reduction: An Anatomic and Radiographic Study

Cited by 6 publications

References 13 publications

Retrospective Radiographic Study of Degenerative Joint Disease in Cats: Prevalence Based on Orthogonal Radiographs

Retrospective Radiographic Study of Degenerative Joint Disease in Cats: Prevalence Based on Orthogonal Radiographs

Triple suture fixation for displaced comminuted olecranon fracture with a stable ulnohumeral joint

Incidence and Management of Articular Impaction in Geriatric Olecranon Fractures

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