Can low-profile double-plate osteosynthesis for olecranon fractures reduce implant removal? A retrospective multicenter study
| Autor: | Mara Warnhoff, Reinhard Hoffmann, Kilian Wegmann, Alexander Ellwein, Michael Hackl, Helmut Lill, Alexander Klug, L. P. Müller, Yves Gramlich |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Olecranon Elbow Implant removal Fracture Fixation Internal Young Adult 03 medical and health sciences 0302 clinical medicine Elbow Joint Humans Medicine Orthopedics and Sports Medicine Olecranon Process Range of Motion Articular Device Removal Aged Retrospective Studies Aged 80 and over 030222 orthopedics Osteosynthesis business.industry 030229 sport sciences General Medicine Middle Aged medicine.disease Ulna Fractures Surgery Treatment Outcome medicine.anatomical_structure Plate osteosynthesis Olecranon fracture Female business Complication Range of motion Bone Plates |
| Zdroj: | Journal of Shoulder and Elbow Surgery. 29:1275-1281 |
| ISSN: | 1058-2746 |
| Popis: | Background Because of poor soft-tissue coverage at the proximal ulna and prominent posteriorly positioned implants, hardware removal remains the most common reason for revision surgery of olecranon fractures that were operatively treated using plate osteosynthesis. We hypothesized that low-profile double-plate osteosynthesis would reduce the number of soft tissue–related hardware removals compared with single posterior plating whereas the functional results would be comparable. Methods This study retrospectively included patients who were treated with low-profile double-plate osteosynthesis or a posterior 2.7-/3.5-mm locking compression plate (LCP) for isolated olecranon fractures from 3 study centers. In addition to the implant removal rate, functional outcome measures (range of motion; Mayo Elbow Performance Score; Disabilities of the Arm, Shoulder and Hand score) were statistically compared. Results The study included 79 patients, with a mean follow-up period of 36 months (range, 24-77 months). Of these patients, 37 were treated with low-profile double-plate osteosynthesis and 42, with a 2.7-/3.5-mm LCP. The mean age was 57 years (range, 18-93 years). Range of motion after treatment with low-profile double-plate osteosynthesis and a 2.7-/3.5-mm LCP measured 129° (range, 80°-155°) and 139° (range, 100°-155°), respectively. The Mayo Elbow Performance Scores were 95 (range, 65-100) and 99 (range, 85-100), respectively (P = .028), and the Disabilities of the Arm, Shoulder and Hand scores were 5.0 (range, 0-49) and 4.6 (range, 0-28), respectively (P = .673). Hardware was removed in 32% and 50% of patients after treatment with double-plate osteosynthesis and a 2.7-/3.5-mm LCP, respectively (P = .11). Hardware removal owing to soft-tissue irritation was noted in 27% of patients after double-plate osteosynthesis and 38% after LCP treatment (P = .30). Discussion Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes. However, the rate of hardware removal was not significantly reduced, and the functional results were comparable to those of common single–posterior plate osteosynthesis. |
| Databáze: | OpenAIRE |
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