Short-term Outcomes of Herbert Screw Fixation for Isolated Olecranon Fractures in Children: a Single-institution Retrospective Study

Abstract

Background: Although various fixation methods can be used for the treatment of displaced olecranon fractures, there are no clear indications in the current literature regarding which surgical technique should be adopted. In this study, we evaluated the clinical and radiological outcomes of closed reduction with percutaneous Herbert screw fixation in children with isolated olecranon fractures.Methods: We retrospectively reviewed the records of children treated at our center for isolated olecranon fractures (Mayo type IIA) with closed reduction and percutaneous Herbert screw fixation between January 2016 and December 2018. Radiographic assessment of fracture healing was performed 6–8 months postoperatively and included assessment for loss of reduction and maximum length of the ulna. Clinical outcomes included elbow flexion and extension, forearm pronation and supination, short version of the Disabilities of the Arm, Shoulder, and Hand (QuickDASH) score, and complications. The Herbert screws were removed by a second operation.Results: A total of 14 patients with an average age at the time of injury of 11.36 (range, 10–14) years were included. All patients had good radiological and clinical outcomes at 6–8 months postoperatively; all had normal elbow ranges of motion and showed complete bone healing on radiographs. There were no cases of foreign body irritation, implant migration, or osteoarthritis. Premature epiphyseal closure was noted in six patients. The average QuickDASH score was 1.58. Conclusions: Fixation of olecranon fractures with Herbert screws is a safe and easy fixation method in young patients, leading to good functional and radiological results. Nonetheless, determination of the effects of this treatment method on the olecranon ossification center requires long-term follow-up.