A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures

Bo-Kun Kim; Hyun-Dae Shin; Kyung-Cheon Kim; Yoo-Sun Jeon

doi:10.4055/jkoa.2011.46.2.146

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Kim, Shin, Kim, and Jeon: A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures

Original Article

Journal of the Korean Orthopaedic Association

Journal of the Korean Orthopaedic Association 2011; 46(2): 146-151.

Published online: 22 April 2011

DOI: https://doi.org/10.4055/jkoa.2011.46.2.146

A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures

Bo-Kun Kim, M.D.^*, Hyun-Dae Shin, M.D., Ph.D., Kyung-Cheon Kim, M.D., Ph.D., Yoo-Sun Jeon, M.D.

Department of Orthopaedic Surgery, Chungnam National University, College of Medicine, Daejeon, Korea.

^*Department of Orthopaedic Surgery, Dong-A University, College of Medicine, Busan, Korea.

Correspondence to: Hyun-Dae Shin, M.D., Ph.D. Department of Orthopaedic Surgery, Chungnam National University, College of Medicine, 33, Munwha-ro, Jung-gu, Daejeon 301-747, Korea. TEL: +82-42-280-7349, FAX: +82-42-252-7098, hyunsd@cnu.ac.kr

Received 20 April 2010 Accepted 19 November 2010

(open-access):

"This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited."

Abstract

Purpose

To analyze the clinical result of a contoured plate fixation using a bicortical screw and a double plate fixation in the surgical treatment of an adult's comminuted olecranon fracture.

Materials and Methods

A total of 22 patients were classified by Mayo classification as Type IIB (17) and Type IIIB (5). All patients enrolled in the study were treated between July 2002 and September 2009. Twelve patients were operated on using the contoured plate internal fixation using a bicortical screw procedure classified as group 'A'. The 10 patients operated on by a double plate fixation were classified as group 'B'. The Mayo elbow performance score was used to compare postoperative clinical results based on total points in 4 categories: pain, range of motion, articular stability, and articular function.

Results

The clinical results of using the Mayo elbow performance score of group 'A' were that 10 scored in the 'excellent' range and 2 scored in the 'good' range the following: in group 'B' were in the excellent range and 3 were in the good range. Both groups showed satisfactory results. Postoperative elbow exercises in group 'A' commenced 7.8 (5-14) days on average, postoperatively. For 'B' group, post-operative elbow exercises began 4.5 (3-7) days following the operation. With regard to the exercise and the range of elbow motion, group 'A' averaged 113.5 degrees and group 'B' averaged 112 degrees. After surgery, the average durations until the bone union were 3.8 (2.4-5.6) months for group 'A' and 4 (2.5-5) months for group 'B', respectively.

Conclusion

There was no significant difference in the clinical results between patients treated with the contoured plate internal fixation using a bicortical screw or the internal fixation using a double plate in the surgical treatment of adults with comminuted olecranon fracture or dislocation. Therefore, both types of operative approach are acceptable.

Keywords: comminuted olecranon fracture, bicortical screw, contoured plate, double plate

Figures and Tables

Figure 1

(A) Preoperative simple radiograph shows Mayo type IIB olecranon fracture. (B) The fracture was fixed by contoured plate using bicortial screws internally. (C) At 12 months after surgery, simple radiographs show solid union of fracture site and no loosening of plate.

Figure 2

(A) Preoperative simple radiograph shows Mayo type IIIB olecranon fracture. (B) The fracture was fixed by double plates internally. (C) At 12 months after surgery, follow-up radiographs show rigid fixation.

Table 1

Comparative Study of Groups A & B (Mayo Classification) in This Study

Table 2

Final Clinical Results of Mayo Elbow Performance Score in This Study (p>0.05)

Table 3

Final Clinical Results of Each Group in This Study

Table 4

Fisher's Exact Test for MEPS (N(%))

MEPS, mayo elbow performance score; p=0.6241.

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