Surgical interventions for treating fractures of the olecranon in adults

Matar, Hosam E; Ali, Amjid; Buckley, S; Garlick, Nicholas; Atkinson, Henry Dushan

doi:10.1002/14651858.cd010144

Cited by 16 publications

(35 citation statements)

References 17 publications

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“…Previous studies have suggested that fixation using intramedullary cannulated screws is technically challenging and unreliable [11,[15][16][17][18], but we found that this technique lead to acceptable surgical results, good patient-reported outcomes, and low rates of implant removal with reasonable operative times (average 45 min). When surgical treatment is indicated, several treatment options, such as tension-band wiring, plate fixation, intramedullary screw fixation and intramedullary nail fixation have been described [1][2][3][4][5][7][8][9][10][11]. These techniques differ in their method of fixation and have their own advantages and disadvantages, but a recent Cochrane review found that none was definitively preferable based on available evidence [2].…”

Section: Discussionmentioning

confidence: 99%

“…When surgical treatment is indicated, several treatment options, such as tension-band wiring, plate fixation, intramedullary screw fixation and intramedullary nail fixation have been described [1][2][3][4][5][7][8][9][10][11]. These techniques differ in their method of fixation and have their own advantages and disadvantages, but a recent Cochrane review found that none was definitively preferable based on available evidence [2]. Tension-band wiring has shown excellent results with regard to union rates [2,3,9] and remains the first choice of treatment for many due to the low complexity and costs of the [8,9].…”

Section: Discussionmentioning

confidence: 99%

“…These techniques differ in their method of fixation and have their own advantages and disadvantages, but a recent Cochrane review found that none was definitively preferable based on available evidence [2]. Tension-band wiring has shown excellent results with regard to union rates [2,3,9] and remains the first choice of treatment for many due to the low complexity and costs of the [8,9]. Yet, implant removal is often necessary due to hardware irritation or k-wire migration in up to 82% of patients [3,7].…”

Section: Discussionmentioning

confidence: 99%

“…Traction of the triceps on the proximal fragment often leads to disruption of articular congruity and of the elbow's extension mechanism. As a result, this injury is typically treated with open reduction and internal fixation (ORIF) [1][2][3][4][5]. Common techniques to treat simple olecranon fractures are tension-band wiring and plate fixation [1][2][3][4][5][6][7][8][9][10][11].…”

Section: Introductionmentioning

confidence: 99%

“…As a result, this injury is typically treated with open reduction and internal fixation (ORIF) [1][2][3][4][5]. Common techniques to treat simple olecranon fractures are tension-band wiring and plate fixation [1][2][3][4][5][6][7][8][9][10][11]. As the skin is thin at the proximal ulna with relatively little subcutaneous tissue, these fixation methods often lead to implant-related soft-tissue irritation necessitating implant removal in 68-82% of the cases largely based on the fixation method that was used [3][4][5]12].…”

Section: Introductionmentioning

confidence: 99%

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Intramedullary screw fixation for simple displaced olecranon fractures

Bosman

Emmink

Bhashyam

et al. 2019

Eur J Trauma Emerg Surg

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Purpose Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. Methods We identified 15 patients (average age at index procedure 44 years, range 16-83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8-36 months). Results By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135-160) and the average extension lag was 11° (range 0-30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. Conclusions Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Intramedullary screw fixation for simple displaced olecranon fractures

Bosman

Emmink

Bhashyam

et al. 2019

Eur J Trauma Emerg Surg

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Surgical interventions for treating fractures of the olecranon in adults

Matar¹,

Ali

Buckley

et al. 2014

Cochrane Database of Systematic Reviews

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BackgroundFractures of the olecranon (the bony tip of the elbow) account for approximately 1% of all upper extremity fractures. Surgical intervention is often required to restore elbow function. Two key methods of surgery are tension band wire fixation and plate fixation. ObjectivesTo assess the effects (benefits and harms) of different surgical interventions in the treatment of olecranon fractures in adults.

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Comparison of two surgical techniques for the treatment of transverse olecranon fractures: A finite element study

Ci̇van

Yildiz

2021

Robotics Computer Surgery

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Background In this study, we aimed to compare the stability of traditional tension band wiring (TBW) and screw combined TBW (SC‐TBW) fixation methods performed for a transverse olecranon osteotomy‐fracture during different degrees of elbow movement by using finite element analysis. Methods Three‐dimensional solid modeling of the olecranon was obtained by computed tomography images. Transverse olecranon fracture was created and fixed by TBW and SC‐TBW with respect to triceps muscle force. Opening angle, twisting angle and interplanar translation occurring on the fracture line were evaluated at 45° and 90° elbow flexion. Results Opening angle: 0.71°, 0.87° at 45° and 0.64°, 0.67° at 90° elbow flexion for TBW and SC‐TBW, respectively. Twisting angle: −0.01°, −0.19° at 45° flexion and 0.19°, 0.30° at 90° flexion for TBW and SC‐TBW, respectively. Interplanar translation: 1.93 mm, 4.65 mm at 45° flexion and 1.78 mm, 3.95 mm at 90° flexion for TBW and SC‐TBW, respectively. Conclusion TBW fixation provides more stability than SC‐TBW fixation model.

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Surgical interventions for treating fractures of the olecranon in adults

Cited by 16 publications

References 17 publications

Intramedullary screw fixation for simple displaced olecranon fractures

Intramedullary screw fixation for simple displaced olecranon fractures

Surgical interventions for treating fractures of the olecranon in adults

Comparison of two surgical techniques for the treatment of transverse olecranon fractures: A finite element study

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