The Evolution of Olecranon Fractures and Its Fixation Strategies.

Autor: Tan BY; Department of Orthopaedic Surgery, Woodlands Health Campus, National Healthcare Group, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore., Ng J; Ministry of Health Holdings, Singapore, Singapore., Ng WX; Ministry of Health Holdings, Singapore, Singapore., Wei Y; Department of Orthopaedic Surgery, Woodlands Health Campus, National Healthcare Group, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore., Kwek EBK; Department of Orthopaedic Surgery, Woodlands Health Campus, National Healthcare Group, 11 Jalan Tan Tock Seng, Singapore, 308433 Singapore.
Jazyk: angličtina
Zdroj: Indian journal of orthopaedics [Indian J Orthop] 2022 May 17; Vol. 56 (8), pp. 1385-1393. Date of Electronic Publication: 2022 May 17 (Print Publication: 2022).
DOI: 10.1007/s43465-022-00646-z
Abstrakt: Introduction: Olecranon fractures are a common fracture of the upper extremity. The primary aim was to investigate the evolution of olecranon fractures and fixation method over a period of 12 years. The secondary aim was to compare complication rates of Tension Band Wiring (TBW) and Plate Fixation (PF).
Materials and Methods: Retrospective Study for all patients with surgically treated olecranon fractures from 1 January 2005 to 31 December 2016 from a tertiary trauma center. Records review for demographic, injury characteristics, radiographic classification and configuration, implant choices and complications. Results grouped into three 4-year intervals, analyzed comparatively to establish significant trends over 12 years.
Results: 262 patients were identified. Demographically, increasing mean age (48.7 to 58.9 years old, p value 0.004) and higher ASA scores (7.1% ASA 3 to 21.0% ASA 3 p value 0.001). Later fractures were more oblique (fracture angle 86.1-100.0 degrees, p value 0.001) and comminuted (Schatzker D type 10.4-30.0%, p value 0.025, single fracture line 94.0-66.0%, p value 0.001). Implant choice, sharp increase in PF compared to TBW (PF 16.0% to PF 80.2%, p value 0.001). Complication-wise, TBW had higher rates of symptomatic implant, implant and bony failures and implant removal.
Conclusion: Demographic and fracture characteristic trends suggest that olecranon fractures are exhibiting fragility fracture characteristics (older age, higher ASA scores, more unstable, oblique and comminuted olecranon fractures). Having a high index of suspicion would alert surgeons to consider use of advanced imaging, utilize appropriate fixation techniques and manage the underlying osteoporosis for secondary fracture prevention. Despite this, trends suggest a potential overutilization of PF particularly for stable fracture patterns and the necessary precaution should be exercised.
Competing Interests: Conflict of InterestAll authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.
(© Indian Orthopaedics Association 2022.)
Databáze: MEDLINE
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