Treatment of Transverse Olecranon Fractures: Comparison Between Tension Band Wiring And Transcortical Screw

Bhattacharyya, Tulasidas; Frank, Herman Conrad; Hazarika, Kishore; Mittal, Saksham

doi:10.9790/0853-1509039396

“…Apart from the previous publication by the senior author, there are only two other publications which report the clinical results of bicortical screw fixation of olecranon fractures and the results were equally as promising as those reported in the present study. 16 - 18 Uhlmann et al 17 reported the results of a prospective series of 13 Schatzker type A (minimally displaced, transverse) olecranon fractures treated with percutaneous bicortical screw fixation these were compared to a control group of 26 patients treated with TBW fixation. The mean and maximum ages of patients treated in Ullmann et al’s series with bicortical screws was 43.6 years and 67.1 years, which was less than those treated in the present series.…”

Section: Discussionmentioning

confidence: 99%

“…Bhattacharyya et al 18 conducted a randomized controlled trial (RCT) of TBW versus bicortical screw fixation for transverse olecranon fractures in patients between the ages of 18 years and 70 years. In all, 20 patients were randomized to each treatment group.…”

Section: Discussionmentioning

confidence: 99%

“…Bhattacharyya et al did not report any cases of loss of reduction or re-operation in the bicortical screw fixation group. 18 …”

Section: Discussionmentioning

confidence: 99%

“…The two cases of loss of reduction occurred in patients > 75 years with osteoporotic bone. Because of age, neither of these patients would have been included in the RCT performed by Bhattacharyya et al 18 One of the cases of loss of reduction occurred as the result of a further fall four weeks postoperatively and screw insertion too close to the fracture ( Figure 4 ). On review of the intra-operative imaging, the second case of loss of reduction may have been caused by suboptimal placement of one of the bicortical screws resulting in compromised screw thread hold on the anterior ulna cortex.…”

Section: Discussionmentioning

confidence: 99%

“… 16 , 17 The reported results of fixation with two bicortical screws for olecranon fracture are promising with lower complication rates than TBW fixation. 16 - 18 The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws.…”

Section: Introductionmentioning

confidence: 99%

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Olecranon fixation with two bicortical screws

Gill

¹

,

Vermuyten

²

,

Schenk

³

et al. 2020

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Aims The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws. Methods Data was collected retrospectively for all olecranon fractures and osteotomies fixed with two bicortical screws between January 2008 and December 2019 at our institution. The following outcome measures were assessed; re-operation, complications, radiological loss of reduction, and elbow range of flexion-extension. Results Bicortical screw fixation was used to treat 17 olecranon fractures and ten osteotomies. The mean age of patients being treated for olecranon fracture and osteotomy were 48.6 years and 52.7 years respectively. Overall, 18% of olecranon fractures were classified as Mayo type I, 71% type II, and 12% type III. No cases of fracture or osteotomy required operative re-intervention. There were two cases of loss of fracture reduction which occurred in female patients ≥ 75 years of age with osteoporotic bone. In both cases, active extension and a functional range of movement was maintained and so the loss of reduction was managed non-operatively. For the fracture fixation cohort, at final follow-up mean elbow extension and flexion were -5° ± 5° and 136° ± 7°, with a mean arc of motion of 131° ± 11°. Conclusion This series has shown that patients regain near full range of elbow flexion-extension and complication rates are low following bicortical screw fixation of olecranon fractures and osteotomy. Cite this article: Bone Joint Open 2020;1-7:376–382.

show abstract

Olecranon fixation with two bicortical screws

Gill

¹

,

Vermuyten

²

,

Schenk

³

et al. 2020

View full text Add to dashboard Cite

Aims The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws. Methods Data was collected retrospectively for all olecranon fractures and osteotomies fixed with two bicortical screws between January 2008 and December 2019 at our institution. The following outcome measures were assessed; re-operation, complications, radiological loss of reduction, and elbow range of flexion-extension. Results Bicortical screw fixation was used to treat 17 olecranon fractures and ten osteotomies. The mean age of patients being treated for olecranon fracture and osteotomy were 48.6 years and 52.7 years respectively. Overall, 18% of olecranon fractures were classified as Mayo type I, 71% type II, and 12% type III. No cases of fracture or osteotomy required operative re-intervention. There were two cases of loss of fracture reduction which occurred in female patients ≥ 75 years of age with osteoporotic bone. In both cases, active extension and a functional range of movement was maintained and so the loss of reduction was managed non-operatively. For the fracture fixation cohort, at final follow-up mean elbow extension and flexion were -5° ± 5° and 136° ± 7°, with a mean arc of motion of 131° ± 11°. Conclusion This series has shown that patients regain near full range of elbow flexion-extension and complication rates are low following bicortical screw fixation of olecranon fractures and osteotomy. Cite this article: Bone Joint Open 2020;1-7:376–382.

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A comparative study of outcome of tension band wiring and hook plating in fracture olecranon

Mahajan

¹

,

Khanna

²

,

Kushwah

³

et al. 2023

Int J Res Orthop

0

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Background: Olecranon fractures are common upper limb fracture accounting for 40% of the fractures around elbow. Anatomic reduction and restoration of the joint surface is required for good outcome and to prevent post-traumatic arthritis. This study was directed towards the functional results and complications of surgical management of olecranon fracture treated with hook plate fixation and tension band wiring. Methods: This prospective comparative study was done at a tertiary care centre from 2019 to 2022. This study consisted of 30 patients of fracture olecranon of which 15 were treated with tension band wiring and 15 with hook plate. All patients were followed up with minimum follow up of six months and evaluated for their functional outcome using Mayo elbow performance score. Results: In this study, the average age was 34 years in TBW group and 37 years in hook plate group. The mean Mayo elbow performance score after 6 months in TBW group was 88.33 (excellent) and in plate group was 90 (excellent). Superficial infection was present in 2 patients of the TBW group. Elbow stiffness was present in 2 patients of TBW group. Hardware impingement was present in one patient in each of TBW group and plate group. Conclusions: To achieve early movements and to prevent complications like traumatic arthritis and joint stiffness we need a perfect anatomical reduction in intra-articular fractures of the olecranon. This study showed no significant difference in functional outcome with both the techniques, but the complications are more with TBW.

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Treatment of Transverse Olecranon Fractures: Comparison Between Tension Band Wiring And Transcortical Screw

Cited by 3 publications

References 13 publications

Olecranon fixation with two bicortical screws

Olecranon fixation with two bicortical screws

Olecranon fixation with two bicortical screws

A comparative study of outcome of tension band wiring and hook plating in fracture olecranon

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