Long-term Functional Consequences of Surgically Treated Pediatric and Adolescent Olecranon Fractures: Does the Presence of Associated Fractures and Surgical Procedure Affect the Results?

Abstract

Background: Olecranon fractures are rare conditions in childhood. The aim of this study was to investigate the factors affecting the results in surgically treated pediatric and adolescent olecranon fractures. Methods: The orthopaedic trauma database of a large academic tertiary center was retrospectively searched for patients who had sustained an olecranon fracture and were treated surgically between 2005 and 2021. Data related to demographic features, additional fractures, and the presence of any disease were obtained from the patient files. Mayo elbow performance score and the Turkish-language version of the shortened version of the disabilities of arm, shoulder, and hand scale were the main functional outcome measurements. Results: The study included 37 elbows of 34 patients with an average age at the time of surgery of 10.9±3.1 years. The mean follow-up period was 78.2±48.0 months (range, 12 to 196 mo). The 1-year fracture rate of contralateral olecranon was 75% in osteogenesis imperfecta patients. Concomitant fractures were 7 proximal radius, 1 medial epicondyle, and 2 capitellum fractures. The surgical treatment methods were tension band wiring (TBW), open reduction and isolated K-wire fixation, closed reduction and percutaneous fixation (CR-PP), and open reduction-plate fixation. The mean implant removal time in patients treated with closed reduction and percutaneous fixation was 2.2 months, open reduction and isolated K-wire fixation 4.7 months, and TBW 12.7 months (P=0.004). The mean disabilities of arm, shoulder, and hand scale was 1.9. The mean Mayo elbow performance score was 100. Grade 1 elbow arthritis was determined in 3 patients. No patient underwent revision surgery. Conclusions: All treatment modalities provided excellent long-term functional results and low complication rates without the need for revision. Closed reduction-percutaneous fixation and open reduction-isolated K-wire fixation were associated with shorter implant removal times compared with TBW. Level of Evidence: Level III.