Olecranon Fracture. A New Therapeutic Alternative
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Published:
Aug 31, 2022
Keywords:
Olecranon fracture, high strength suture, intramedullary screw
Main Article Content
Abstract
Objective: Displaced olecranon fractures mostly require surgical fixation. The most commonly used techniques are tension band wiring and plate fixation, but they are associated with high rates of discomfort due to soft tissue irritation. An alternative surgical option is fixation with high-strength sutures with intramedullary screws. The aim of this study is to evaluate the range of motion, bone healing and complications using this technique.
Materials and Methods: Six patients with type IIA fractures with an average age of 43 years (range 24-60 years) treated with high strength suture and intramedullary screw between January 2020 - April 2021 were included. Post-operative range of motion, bone healing and complications were evaluated. All were evaluated up to 6 months postoperatively.
Results: At the 6th postoperative month, the average flexion was 143º (range 90º-160º), average extension 19º (0º-55º), there was bone healing in 5 patients, and 1 nonunion with joint stiffness (complication 16.6%). There were no second surgeries.
Conclusion: Simple displaced olecranon fractures treated with high-strength suture with intramedullary screws is a simple, reproducible and economical technique since it does not require a second surgery, as is the case with traditional fixation methods for this pathology.
Materials and Methods: Six patients with type IIA fractures with an average age of 43 years (range 24-60 years) treated with high strength suture and intramedullary screw between January 2020 - April 2021 were included. Post-operative range of motion, bone healing and complications were evaluated. All were evaluated up to 6 months postoperatively.
Results: At the 6th postoperative month, the average flexion was 143º (range 90º-160º), average extension 19º (0º-55º), there was bone healing in 5 patients, and 1 nonunion with joint stiffness (complication 16.6%). There were no second surgeries.
Conclusion: Simple displaced olecranon fractures treated with high-strength suture with intramedullary screws is a simple, reproducible and economical technique since it does not require a second surgery, as is the case with traditional fixation methods for this pathology.
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How to Cite
Cabrera, M. N., & Caló, L. N. (2022). Olecranon Fracture. A New Therapeutic Alternative. Revista De La Asociación Argentina De Ortopedia Y Traumatología, 87(4), 526-533. https://doi.org/10.15417/issn.1852-7434.2022.87.4.1608
Section
Clinical Research
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References
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https://doi.org/10.2106/JBJS.L.01137
5. Labrum JT 4th, Foster BD, Weikert DR. Augmented intramedullary screw tension band construct for olecranon
fracture reduction and fixation: a review of literature and surgical technique. JSES Int 2020;4(3):470-7.
https://doi.org/10.1016/j.jseint.2020.04.005
6. Nimura A, Nakagawa T, Wakabayashi Y, Sekiya I, Okawa A, Muneta T. Repair of olecranon fractures using
fiberWire without metallic implants: report of two cases. J Orthop Surg Res 2010;5:73. https://doi.org/10.1186/1749-799X-5-73
7. Nazifi O, Gunaratne R, D’Souza H, Tay A. The use of strength sutures and anchors in olecranon fractures: A
systematic review. Geriatric Orthop Surg Rehab 2021;12:2151459321996626. https://doi.org/10.1177/2151459321996626
8. Snoddy M, Gunaratne R, D’Souza H, Tay A. Olecranon fractures: factors influencing re-operation. Int Orthop
2014;38(8):1711-6. https://doi.org/10.1177/2151459321996626
9. Duckworth AD, Clement ND, White TO, Court-Brown CM, McQueen MM. Plate versus tension-band wire fixation for olecranon fractures: a prospective randomized trial. J Bone J Surg Am 2017;99(15):1261-73.
https://doi.org/10.2106/JBJS.16.00773
10. Nork SE, Jones CB, Henley MB. Surgical treatment of olecranon fractures. Am J Orthop (Belle Mead NJ)
2001;30:577-86. PMID: 11482514
11. Claessen FMAP, Braun Y, Peters RM, Dyer G, Doornberg JN, Ring D. Factors associated with reoperation after
fixation of displaced olecranon fractures. Clin Orthop Relat Res 2016;474(1):193-200. https://doi.org/10.1007/s11999-015-4488-2
12. Carofino BC, Santangelo SA, Kabadi M, Mazzocca AD, Browner BD. Olecranon fractures repaired with Fiberwire or metal wire tension banding: a biomechanical comparison. Arthroscopy 2007;23(9):964-70.
https://doi.org/10.1016/j.arthro.2007.03.008
13. Coles CP, Barei DP, Nork SE, Taitsman LA, Hanel DP, Bradford Henley M. The olecranon osteotomy: a six-year
experience in the treatment of intraarticular fractures of the distal humerus. J Orthop Trauma 2006;20(3):164-71.
https://doi.org/10.1097/00005131-200603000-00002
14. Woods BI, Rosario BL, Siska PA, Gruen GS, Tarkin IS, Evans AR. Determining the efficacy of screw and washer
fixation as a method for securing olecranon osteotomies used in the surgical management of intraarticular distal
humerus fractures. J Orthop Trauma 2015;29(1):44-9. https://doi.org/10.1097/BOT.0000000000000131
15. Wagener M, Dezillie M, Hoendervangers Y, Eygendaal D. Clinical results of re-fixation of a Chevron olecranon
osteotomy using an intramedullary cancellous screw and suture tension band. Strategies Trauma Limb Reconstr
2015;10(1):1-4. https://doi.org/10.1007/s11751-015-0211-9
16. De Giacomo AF, Tornetta P 3rd, Sinicrope BJ, Cronin PK, Althausen PL, Bray TJ, et al. Outcomes after plating of
olecranon fractures: a multicenter evaluation. Injury 2016;47(7):1466-71. https://doi.org/10.1016/j.injury.2016.04.015
17. Delsole EM, Pean CA, Tejwani NC, Egol KA. Outcome after olecranon fracture repair: does construct type matter? Eur J Orthop Surg Traumatol 2016;26(2):153-9. https://doi.org/10.1007/s00590-015-1724-0
18. Gathen M, Jaenisch M, Peez C, Weinhold L, Schmid M, Welle K, et al. Plate fixation and tension band wiring after isolated olecranon fracture comparison of outcome and complications. J Orthop 2020;18:69-75.
https://doi.org/10.1016/j.jor.2019.09.017
19. Newman SDS, Mauffrey C, Krikler S. Olecranon fractures. Injury 2009;40:575-81. https://doi.org/10.1016/j.injury.2008.12.013
20. Ren Y-M, Qiao H-Y, Wei Z-J, Lin W, Fan B-Y, Liu J, et al. Efficacy and safety of tension band wiring versus plate
fixation in olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res 2016;11(1):137.
https://doi.org/10.1186/s13018-016-0465-z
21. Brolin TJ, Throckmorton T. Olecranon fractures. Hand Clin 2015;31(4):581-90. https://doi.org/10.1016/j.hcl.2015.07.003
22. Lalliss SJ, Branstetter JG. The use of three types of sutures and stainless-steel wire tension banding for the fixation of simulated olecranon fractures: a comparison study in cadaver elbows. J Bone Joint Surg Br 2010;92(2):315-9. https://doi.org/10.1302/0301-620X.92B2.22596
23. Bosman W, Emmink B, Bhashyam A, Houwert R, Keizer J. Intramedullary screw fixation for simple displaced
olecranon fractures. Eur J Trauma Emerg Surg 2020;46(1):83-9. https://doi.org/10.1007/s00068-019-01114-4
proximal ulna. Injury 2012;43(3):343-6. https://doi.org/10.1016/j.injury.2011.10.017
2. Wiegand L, Bernstein J, Ahn J. Fractures in brief: olecranon fractures. Clin Orthop Relat Res 2012;470(12):3637-
41. https://doi.org/10.1007/s11999-012-2393-5
3. Amis AA, Miller JH. The mechanisms of elbow fractures: an investigation using impact tests in vitro. Injury
1995;26(3):163-8. https://doi.org/10.1016/0020-1383(95)93494-3
4. Duckworth AD, Bugler KE, Clement ND, Court-Brown CM, McQueen M. Nonoperative management of displaced olecranon fractures in low-demand elderly patients. J Bone Joint Surg Am 2014;96(1):67-72.
https://doi.org/10.2106/JBJS.L.01137
5. Labrum JT 4th, Foster BD, Weikert DR. Augmented intramedullary screw tension band construct for olecranon
fracture reduction and fixation: a review of literature and surgical technique. JSES Int 2020;4(3):470-7.
https://doi.org/10.1016/j.jseint.2020.04.005
6. Nimura A, Nakagawa T, Wakabayashi Y, Sekiya I, Okawa A, Muneta T. Repair of olecranon fractures using
fiberWire without metallic implants: report of two cases. J Orthop Surg Res 2010;5:73. https://doi.org/10.1186/1749-799X-5-73
7. Nazifi O, Gunaratne R, D’Souza H, Tay A. The use of strength sutures and anchors in olecranon fractures: A
systematic review. Geriatric Orthop Surg Rehab 2021;12:2151459321996626. https://doi.org/10.1177/2151459321996626
8. Snoddy M, Gunaratne R, D’Souza H, Tay A. Olecranon fractures: factors influencing re-operation. Int Orthop
2014;38(8):1711-6. https://doi.org/10.1177/2151459321996626
9. Duckworth AD, Clement ND, White TO, Court-Brown CM, McQueen MM. Plate versus tension-band wire fixation for olecranon fractures: a prospective randomized trial. J Bone J Surg Am 2017;99(15):1261-73.
https://doi.org/10.2106/JBJS.16.00773
10. Nork SE, Jones CB, Henley MB. Surgical treatment of olecranon fractures. Am J Orthop (Belle Mead NJ)
2001;30:577-86. PMID: 11482514
11. Claessen FMAP, Braun Y, Peters RM, Dyer G, Doornberg JN, Ring D. Factors associated with reoperation after
fixation of displaced olecranon fractures. Clin Orthop Relat Res 2016;474(1):193-200. https://doi.org/10.1007/s11999-015-4488-2
12. Carofino BC, Santangelo SA, Kabadi M, Mazzocca AD, Browner BD. Olecranon fractures repaired with Fiberwire or metal wire tension banding: a biomechanical comparison. Arthroscopy 2007;23(9):964-70.
https://doi.org/10.1016/j.arthro.2007.03.008
13. Coles CP, Barei DP, Nork SE, Taitsman LA, Hanel DP, Bradford Henley M. The olecranon osteotomy: a six-year
experience in the treatment of intraarticular fractures of the distal humerus. J Orthop Trauma 2006;20(3):164-71.
https://doi.org/10.1097/00005131-200603000-00002
14. Woods BI, Rosario BL, Siska PA, Gruen GS, Tarkin IS, Evans AR. Determining the efficacy of screw and washer
fixation as a method for securing olecranon osteotomies used in the surgical management of intraarticular distal
humerus fractures. J Orthop Trauma 2015;29(1):44-9. https://doi.org/10.1097/BOT.0000000000000131
15. Wagener M, Dezillie M, Hoendervangers Y, Eygendaal D. Clinical results of re-fixation of a Chevron olecranon
osteotomy using an intramedullary cancellous screw and suture tension band. Strategies Trauma Limb Reconstr
2015;10(1):1-4. https://doi.org/10.1007/s11751-015-0211-9
16. De Giacomo AF, Tornetta P 3rd, Sinicrope BJ, Cronin PK, Althausen PL, Bray TJ, et al. Outcomes after plating of
olecranon fractures: a multicenter evaluation. Injury 2016;47(7):1466-71. https://doi.org/10.1016/j.injury.2016.04.015
17. Delsole EM, Pean CA, Tejwani NC, Egol KA. Outcome after olecranon fracture repair: does construct type matter? Eur J Orthop Surg Traumatol 2016;26(2):153-9. https://doi.org/10.1007/s00590-015-1724-0
18. Gathen M, Jaenisch M, Peez C, Weinhold L, Schmid M, Welle K, et al. Plate fixation and tension band wiring after isolated olecranon fracture comparison of outcome and complications. J Orthop 2020;18:69-75.
https://doi.org/10.1016/j.jor.2019.09.017
19. Newman SDS, Mauffrey C, Krikler S. Olecranon fractures. Injury 2009;40:575-81. https://doi.org/10.1016/j.injury.2008.12.013
20. Ren Y-M, Qiao H-Y, Wei Z-J, Lin W, Fan B-Y, Liu J, et al. Efficacy and safety of tension band wiring versus plate
fixation in olecranon fractures: a systematic review and meta-analysis. J Orthop Surg Res 2016;11(1):137.
https://doi.org/10.1186/s13018-016-0465-z
21. Brolin TJ, Throckmorton T. Olecranon fractures. Hand Clin 2015;31(4):581-90. https://doi.org/10.1016/j.hcl.2015.07.003
22. Lalliss SJ, Branstetter JG. The use of three types of sutures and stainless-steel wire tension banding for the fixation of simulated olecranon fractures: a comparison study in cadaver elbows. J Bone Joint Surg Br 2010;92(2):315-9. https://doi.org/10.1302/0301-620X.92B2.22596
23. Bosman W, Emmink B, Bhashyam A, Houwert R, Keizer J. Intramedullary screw fixation for simple displaced
olecranon fractures. Eur J Trauma Emerg Surg 2020;46(1):83-9. https://doi.org/10.1007/s00068-019-01114-4