Tension band wiring for simple olecranon fractures: evaluation of surgical technique

Autor: Claessen, Femke MAP, van den Bekerom, Michel PJ, van Dijk, C Niek, Goslings, J Carel, Kerkhoffs, Gino MMJ, Doornberg, Job N, Shouldere elbow platform, on behalf of the, VAN DER BRACHT, HANS, Van Tongel, Alexander
Přispěvatelé: APH - Personalized Medicine, APH - Quality of Care, Orthopedic Surgery and Sports Medicine, AMS - Restoration & Development, Surgery, AMS - Ageing & Morbidty, AMS - Sports & Work, Graduate School, Other departments
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
UPPER-EXTREMITY DISABILITY
medicine.medical_treatment
0302 clinical medicine
RADIAL HEAD
lcsh:Orthopedic surgery
Fracture Fixation
Elbow Joint
Medicine and Health Sciences
Orthopedics and Sports Medicine
030212 general & internal medicine
Orthodontics
Observer Variation
030222 orthopedics
Olecranon fracture
Middle Aged
Ulna Fractures
medicine.anatomical_structure
RELIABILITY
Ligament
Original Article
Female
Elbow trauma
Bone Wires
Adult
medicine.medical_specialty
Olecranon
MEASUREMENT INFORMATION-SYSTEM
CLASSIFICATION
03 medical and health sciences
Fixation (surgical)
Young Adult
Tension band
medicine
Internal fixation
Humans
COMPUTED-TOMOGRAPHY
Olecranon Process
Aged
Disability
business.industry
Tension band wiring
medicine.disease
Surgery
LIGAMENT
lcsh:RD701-811
Orthopedic surgery
Technique pain
business
Elbow Injuries
Zdroj: Journal of Orthopaedics and Traumatology, Vol 18, Iss 3, Pp 275-281 (2017)
Journal of orthopaedics and traumatology, 18(3), 275-281. Springer-Verlag Italia
JOURNAL OF ORTHOPAEDICS AND TRAUMATOLOGY
Journal of Orthopaedics and Traumatology : Official Journal of the Italian Society of Orthopaedics and Traumatology
ISSN: 1590-9999
1590-9921
Popis: Background In some settings, specific techniques for open reduction and internal fixation are preferred based on the eminence of a surgeon or professional organization. An emphasis on technical aspects of surgery that are not proved superior and vary substantially from surgeon to surgeon can be confusing for trainees. This study applied a numerical grading of the technical aspects of tension band wire (TBW) fixation for olecranon fracture; assessed the interobserver agreement of each criterion; and measured the correlation of the technical grading and objective and subjective long-term outcomes. Materials and methods Forty observers were invited to rate the technical aspects of TBW fixation of the olecranon on 26 post-operative radiographs. The interobserver reliability of the rating was measured using the intra-class correlation coefficient. The correlation between the rating and motion, Mayo elbow performance index, and disabilities of the arm, shoulder and hand score was tested with the Spearman’s rank correlation test. Results None of the figure-of-eight TBW constructs were considered perfect according to the numerical grading: the majority of observers found three deviations per fixation. The interobserver agreement was only fair for the total number of deviations and no correlation between the number of deviations and long-term objective and subjective outcome was found. Conclusions A rating of the technical aspects of TBW for olecranon fractures was unreliable and did not correlate with subjective and objective outcomes. Emphasis on specific technical aspects of fixation might be confusing for trainees and could distract them from the principles of effective treatment. Level of evidence Level IV diagnostic study.
Databáze: OpenAIRE
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