Type II olecranon fractures in patients over 65. Tension band or pre-formed plate? Analysis and results

Liñán-Padilla, A.; Cáceres-Sánchez, L.

doi:10.1016/j.recote.2017.08.006

Cited by 2 publications

(1 citation statement)

References 11 publications

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“…Although both operative and nonoperative management yield good outcomes in the elderly population, the complication rate may prove higher in operative fixation, particularly in this demographic characterized by declining bone quality. Our review of the literature on operative fixation of this type of injury reveals a 53% complication rate, where two-thirds (n = 35) of the patients required a second surgery for symptomatic hardware, 9,13,15,17 infection, 9,15 soft tissue breakdown, 17 pseudoarthrosis, 15 nonunion, 13 and heterotopic ossification. 16,17 Removal of hardware comprised the most common indication for reoperation (n = 23; 23%) (see Table 5).…”

Section: Discussionmentioning

confidence: 93%

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Alvara

Biedron

Dunn

2020

Hand (New York, N,Y.)

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Background: Despite increased utilization of conservative measures for displaced olecranon fractures in elderly patients, in whom operative fixation may be complicated by coexisting comorbidities and declining bone quality, the noninferiority of nonoperative management has yet to be proven. The purpose of this study was to review nonoperative management of displaced olecranon fractures in the elderly patient population. Methods: A literature search of the PubMed database was performed using the term olecranon fracture. Papers included those with results for patients aged 65 years and older published between 1990 and 2018 in the English language. Data were pooled to analyze outcomes and complications of nonoperative management of olecranon fractures in the elderly patient population. Results: Four eligible studies combined for a total of 69 patients with 70 fractures with an average age of 83.8 years (71-95 years), female predominance of 88%, and a mean follow-up of 12.4 months who underwent nonoperative management of displaced olecranon fractures. While only 25% of fractures went on to radiographic union, the mean Disabilities of the Arm, Shoulder, and Hand score was 16.9 (0-59.6), the mean arc of motion was 138°, and 92% of patients achieved excellent results. One-quarter (26%) of the patients experienced complications: radial head subluxation (1), skin sore (1), degenerative arthropathy (1), pain on movement (2), click in movement of the elbow (5), and local pain (8). Conclusion: Displaced olecranon fractures in patients aged older than 70 years may be effectively managed with nonoperative measures to produce high satisfaction and functional range of motion.

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Section: Discussionmentioning

confidence: 93%

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Alvara

Biedron

Dunn

2020

Hand (New York, N,Y.)

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Efficacy and safety of tension band wire versus plate for Mayo II olecranon fractures: a systematic review and meta-analysis

et al. 2022

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Purpose For olecranon fractures, the choice of tension band wire (TBW) or plate fixation has long been controversial. Therefore, this study aimed to evaluate the efficacy and safety of TBW and plate in the treatment of patients with Mayo II olecranon fractures by Meta-analysis. Methods PubMed, Embase, Cochrane, the Web of Science, China National Knowledge Infrastructure, Wanfang, and China Biomedical Database were searched for randomized controlled trials (RCTs) and cohort studies (CSs) where TBW was compared with plate for Mayo II olecranon fractures (OF). Subsequently, the data were extracted by two reviewers independently and were analysed via RevMan5.4.1. Besides, mean difference (MD), risk ratio (RR), and 95% confidence intervals (CIs) were calculated. Furthermore, Cochrane Risk of Bias Tool 2.0 and Newcastle–Ottawa Scale were adopted for assessing the risk of bias. Results A total of 1RCT and 10 CSs were included, when 449 cases were treated with TBW and 378 with plate. The plate has favourable postoperative long-term (≥ 1 year) functional score in MEPS (MD: − 3.06; 95% CI − 5.50 to 0.62; P = 0.01; I2 = 41%) and Dash score (MD: 2.32; 95% CI 1.91, 2.73; P < 0.00001; I2 = 0%), also carrying fewer complications (RR: 2.13; 95% CI 1.48, 3.08; P < 0.0001; I2 = 58%). Besides, there exists no significant difference in postoperative long-term (≥ 1 year) elbow flexion (MD: − 1.82°; 95% CI − 8.54, 4.90; P = 0.60; I2 = 71%) and extension deficits (MD: 1.52°; 95% CI − 0.38, 3.42; P = 0.12; I2 = 92%). Moreover, TBW is featured with a shorter operation time (MD = − 5.87 min; 95% CI − 7.93, − 3.82; P < 0.00001; I2 = 0) and less intraoperative bleeding (MD: − 5.33 ml; 95% CI − 8.15, − 2.52; P = 0.0002; I2 = 0). In terms of fracture healing time, it is still controversial. Furthermore, the subgroup analysis has revealed that for Mayo IIA OF, the plate has a better outcome in the long-term (≥ 1 year) postoperative MEPS, the Dash score, and the incidence of postoperative complications than TBW, while there is no significant difference in the long-term (≥ 1 year) postoperative elbow motion between two groups. Conclusions Plate has better efficacy and safety for Mayo II OF. Considering that few studies are included in the meta-analysis, more high-quality RCTs are still required to confirm these findings. PROSPERO registration number: CRD42022313855.

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Type II olecranon fractures in patients over 65. Tension band or pre-formed plate? Analysis and results

Cited by 2 publications

References 11 publications

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Efficacy and safety of tension band wire versus plate for Mayo II olecranon fractures: a systematic review and meta-analysis

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