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

Abstract

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.

Application of a novel shape-memory alloy concentrator in displaced olecranon fractures: a report of the technique and mid-term clinical results

“…Compared with TBW, PF possesses the advantage of an increased stability [31] and is related to lower rates of hardware prominence [34]. Luksic et al [25] reported that in the treatment of comminuted olecranon fractures a new technical tension plate combined with two Kirschner wires could provide adequate stability for early postoperative functional recovery, producing good clinical outcomes and increasing the fracture union rate [25]. However, hardware-related symptoms have been a common complication, with a rate of approximately 56 to 76.2%, leading to a secondary operation for removal [1,12].…”

“…The Mayo Elbow Performance (MEP) score was also used as a comprehensive assessment considering the following four factors: pain, ulnohumeral motion, stability, and the ability to perform five functional tasks [ 24 ]. According to the previous report [ 25 ], the functional range of movement in the operated elbow was flexion ≥ 128°, extension ≥ 116°, and pronation and supination ≥ 72°; when any one of the elbow joints does not meet these 4 criteria, we considered it a loss of the functional range of motion. All the clinical assessments used in this study were performed by independent observers, and the results were independently interpreted by two authors.…”