Intramedullary Screw Fixation of Olecranon Fractures Reduces the Risk of Early Unplanned Reoperation: A Retrospective Review of 556 Patients
| Autor: | Raymond A. Pensy, Logan Reitz, Alexandra Mulliken, Nathan N O'Hara, Zachary D. Hannan, Clifton Meals, Christopher T. Johnson |
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| Rok vydání: | 2022 |
| Předmět: |
Reoperation
medicine.medical_specialty Olecranon medicine.medical_treatment Bone Screws law.invention Screw fixation Intramedullary rod Fracture Fixation Internal Fixation (surgical) law Humans Medicine Internal fixation Orthopedics and Sports Medicine Olecranon Process Reduction (orthopedic surgery) Retrospective Studies business.industry Retrospective cohort study General Medicine medicine.disease Ulna Fractures Fracture Fixation Intramedullary Surgery Treatment Outcome medicine.anatomical_structure Olecranon fracture business |
| Zdroj: | Journal of Orthopaedic Trauma. 36:e24-e29 |
| ISSN: | 0890-5339 |
| DOI: | 10.1097/bot.0000000000002145 |
| Popis: | Objectives To determine the effect of intramedullary screw-based fixation on early postoperative complications after olecranon fractures. We hypothesized that intramedullary screw-based fixation results in decreased need for reoperation compared to plate and screw and tension band-based fixation. Design: Retrospective cohort. Setting 2 academic level-1 trauma centers.Patients / Participants: 556 patients treated with a tension band, plate and screw, or intramedullary-based construct for an olecranon fracture over a 10-year period. Intervention: Open reduction and internal fixation. Main outcome measurement Unplanned reoperation. Demographic, injury type and severity, supplemental fixation, and length of follow up data were viewed as potential confounders and analyzed as such. Results We identified 556 relevant patients. 199 patients were treated with an intramedullary screw-based construct, 229 with a plate and screw-based construct, and 128 with a tension band-based construct. We observed significant differences in the age, fracture type, percentage of open fractures, use of supplemental fixation, and treating institution between the treatment groups. 95 patients (17.1%) had an unplanned reoperation. When we adjusted for confounders, intramedullary screw-based fixation reduced the odds of an unplanned reoperation by 54% compared to plate and screw-based treatment. In the adjusted analysis, we did not observe a difference between plate and screw-based treatment and tension band-based fixation. Conclusions Intramedullary screw-based fixation of olecranon fractures results in decreased need for early reoperation compared with more common olecranon fixation strategies. Level of evidence Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence. |
| Databáze: | OpenAIRE |
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