Trends in Management of Radial Head and Olecranon Fractures

Abstract

Background:Advancement in surgical techniques and implants has improved the ability to manage radial head and olecranon fractures. However, trends in management of these fractures are largely unstudied.Objective:This purpose of this study is to evaluate management trends for these common fractures.Methods:A retrospective review of a comprehensive Humana database was performed using Pearl Diver supercomputer (Warsaw, IN, USA) for radial head and neck (RHNF) and olecranon fractures (OF) between 2007 and 2014. Treatment methods including open reduction internal fixation (ORIF), radial head arthroplasty (RHA), and non-operative treatment were reviewed. Total reported incidence of office visits and utilization of each treatment modality were investigated. Sub-analysis with stratification by age 15-74 and greater than 75-years was performed for OF.Results:A total of 10,609 OF and 20,400 RHNF were identified between 2007 and 2014. A significant trend increase in the annual incidence of RHNF (266 cases/year, p<0.001) and OF (133.9 cases/year, p=0.001) was observed. A significant trend increase in annual percent utilization of RHA (0.22% per year, p=0.011) and a significant trend decrease in the annual percent utilization of ORIF (-1.0% per year, p=0.004) and non-operative management (-0.53% per year, p=0.046) was observed for RHNF. A significant trend increase was observed in percent utilization (0.40% per year, p=0.022) for OF non-operative management, especially in patients over 75 years (66% per year, p=0.034).Conclusion:The percentage of patients being treated with RHA is increasing. Non-operative management of OF has increased, specifically in the patients who are over 75 years.

Functional Outcomes of Unstable Traumatic Elbow Injuries: How and When to Fix Them

“…Our study has achieved a similar result with the few other studies available in the literature [19,[23][24][25][26]. This study has notably reported good to excellent results with adequate multi-dimensional surgical treatment.…”

“…Algorithms for unstable elbow injuries were created to simplify the flow of operative decision making.We followed it for all the patients included in the study and achieved good results according to the MEPS. Compared with other similar studies, the strength of this paper is that there were no poor results amongst our cohorts [19][20][21][22].…”

“…Each technique has proven to add some benefit to improve elbow stability or reduce associated complications [15][16][17][18]. No single surgical technique -to our knowledge-has been determined more superior than others [19].Planning to manage these types of injuries have to take into consideration tailored indications and patient needs [19]. Though one fact remains clear, that any non-surgical intervention will result in assertive disabilities to the joint [20][21][22].…”

An Individualized Intra-Articular Stabilization Device Designed Based on 3D Printing Technology for Traumatic Instability of the Ulnohumeral Joint

“…To increase elbow stability and perform early functional exercises for patients with terrible triad of the elbow, some scholars advocate the combined use of a hinged external fixator. Motisi et al [ 16 ] found that a hinged external fixator effectively maintained elbow stability, prevented elbow dislocation, and achieved a satisfactory clinical effect in 35 patients with terrible triad of the elbow.…”

Radial head replacement versus reconstruction for the treatment of the terrible triad injury of the elbow: a systematic review and meta-analysis

“…In particular, the decision to either fix or replace the radial head remains controversial. There has, however, been a recent trend observed towards an increase in the use of REP in radial head fractures, as arthroplasty provides early stability and may allow mobilisation sooner, potentially resulting in a better functional outcome [ 11 , 12 ].…”