The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture

In-Tae Hong; Kyunghun Jung; Yoon Seok Kim; Soo-Hong Han

doi:10.12790/ahm.2019.24.2.133

Journal List > Arch Hand Microsurg > v.24(2) > 1125367

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Hong, Jung, Kim, and Han: The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture

Original Article

Arch Hand Microsurg 2019;24(2):133-141.

Published online: 5 January 2019

DOI: https://doi.org/10.12790/ahm.2019.24.2.133

The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture

In-Tae Hong¹, Kyunghun Jung², Yoon Seok Kim³, Soo-Hong Han²

¹Department of Orthopaedic Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Korea

²Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, Korea

³Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea

Corresponding author: Soo-Hong Han Department of Orthopaedic Surgery, CHA Bundang Medical Center, CHA University, 59 Yatap-ro, Bundang-gu, Seongnam 13496, Korea TEL: +82-31-780-5273, FAX: +82-31-708-3578, E-mail: hsoohong@cha.ac.kr

Received 2 January 201913 March 2019 Accepted 28 March 2019

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

초록

Purpose:

Olecranon fractures of Mayo type IIIb occurring in less than 15% of total olecranon fractures usually require open reduction and internal fixation with plate. Concomitant injury to the surrounding soft tissue is common and anatomi-cal reduction is relatively difficult, which may be predictive of poor prognosis compared to simple fracture. We performed open reduction and locking compression plate (LCP) olecranon plate fixation in Mayo type IIIb fractures, and analyzed the results of the treatment.

Methods:

We retrospectively analyzed 29 patients who underwent LCP plate fixation for olecranon fractures of Mayo type IIIb. Twenty four males and 5 females were included, and the average follow-up period was 17 months. Radiograph-ic analysis was performed to assess the stability of the joint, union time of the fracture, and the occurrence of traumatic arthritis at the final follow-up. We analyzed the range of motion of the elbow at the final follow-up, the Mayo elbow performance score (MEPS), the disability of the arm, shoulder and hand (DASH) score, and postoperative complications.

Results:

All cases showed bony union and stable elbow joint on simple plain radiography. On final follow-up radiogra-phy, traumatic arthritis was observed in 1 case. The mean range of motion of the elbow was 129.7^°, the mean MEPS was 88.6, and DASH score was 11.04.

Conclusion:

Based on the results of this study, the satisfactory results can be obtained if appropriate open reduction and stable internal fixation using olecranon LCP plate is achieved in unstable comminuted olecranon fractures.

Keywords: Olecranon, Fracture, Internal fixators, Comminuted fractures

REFERENCES

1.Sahajpal D., Wright TW. Proximal ulna fractures. J Hand Surg Am. 2009. 34:357–62.

2.Horne JG., Tanzer TL. Olecranon fractures: a review of 100 cases. J Trauma. 1981. 21:469–72.

3.Larsen E., Lyndrup P. Netz or Kirschner pins in the treatment of olecranon fractures? J Trauma. 1987. 27:664–6.

4.Gartsman GM., Sculco TP., Otis JC. Operative treatment of olecranon fractures. Excision or open reduction with internal fixation. J Bone Joint Surg Am. 1981. 63:718–21.

5.Hak DJ., Golladay GJ. Olecranon fractures: treatment options. J Am Acad Orthop Surg. 2000. 8:266–75.

6.Akman S., Ertürer RE., Tezer M., Tekeşin M., Kuzgun U. [Long-term results of olecranon fractures treated with tension-band wiring technique]. Acta Orthop Traumatol Turc. 2002. 36:401–7. Turkish.

7.Anderson ML., Larson AN., Merten SM., Steinmann SP. Congruent elbow plate fixation of olecranon fractures. J Orthop Trauma. 2007. 21:386–93.

8.Bailey CS., MacDermid J., Patterson SD., King GJ. Out-come of plate fixation of olecranon fractures. J Orthop Trauma. 2001. 15:542–8.

9.Buijze G., Kloen P. Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures. J Bone Joint Surg Am. 2009. 91:2416–20.

10.Erturer RE., Sever C., Sonmez MM., Ozcelik IB., Akman S., Ozturk I. Results of open reduction and plate osteosynthe-sis in comminuted fracture of the olecranon. J Shoulder Elbow Surg. 2011. 20:449–54.

11.Lee JM., Park JH. Fractures of the olecranon of ulna treated by plating and tension-band wiring technique. J Korean Soc Fract. 1996. 9:801–8.

12.King GJ., Lammens PN., Milne AD., Roth JH., Johnson JA. Plate fixation of comminuted olecranon fractures: an in vitro biomechanical study. J Shoulder Elbow Surg. 1996. 5:437–41.

13.O’Driscoll SW. Technique for unstable olecranon fracture-subluxations. Oper Tech Orthop. 1994. 4:49–53.

14.Gordon MJ., Budoff JE., Yeh ML., Luo ZP., Noble PC. Comminuted olecranon fractures: a comparison of plating methods. J Shoulder Elbow Surg. 2006. 15:94–9.

15.Gardner MJ., Helfet DL., Lorich DG. Has locked plating completely replaced conventional plating? Am J Orthop (Belle Mead NJ). 2004. 33:439–46.

16.Shin HD., Yang JH., Kim PS. Internal fixation using double plates for comminuted olecranon fractures in adults. J Korean Fract Soc. 2009. 22:166–71.

17.Kim BK., Shin HD., Kim KC., Jeon YS. A retrospective comparative study of internal fixation with contoured plate using bicortical screw versus a double plate in comminuted olecranon fractures. J Korean Orthop Assoc. 2011. 46:146–51.

18.Jeong DG., Shin DJ., Byun YS., Park YB., Kim KR. The surgical outcomes of olecranon fracture dislocation of the elbow. J Korean Orthop Assoc. 2017. 52:537–42.

19.Ring D., Jupiter JB., Sanders RW., Mast J., Simpson NS. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma. 1997. 11:545–50.

20.Mouhsine E., Akiki A., Castagna A, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg. 2007. 16:352–7.

21.Ring D., Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg Am. 1998. 80:566–80.

22.Shukla DR., Pillai G., McAnany S., Hausman M., Parsons BO. Heterotopic ossification formation after fracture-dislocations of the elbow. J Shoulder Elbow Surg. 2015. 24:333–8.

23.Eriksson E., Sahlin O., Sandahl U. Late results of conserva-tive and surgical treatment of fracture of the olecranon. Acta Chir Scand. 1957. 113:153–66.

24.Rochet S., Obert L., Lepage D., Lemaire B., Leclerc G., Garbuio P. Proximal ulna comminuted fractures: fixation using a double-plating technique. Orthop Traumatol Surg Res. 2010. 96:734–40.

Fig. 1.

Preoperative plain radiographs and computed tomography scan of 65 years old male who sustained a traffic accident show Mayo type IIIb olecranon fracture.

Fig. 2.

Follow-up radiographs taken at 6 months after surgery show bony union and stable elbow joint.

Fig. 3.

Plate and screws were all removed at 6 months after surgery.

Fig. 4.

Photographs of the patient taken at 1 year after surgery.

Fig. 5.

Preoperative plain radiographs and computed tomography scan of 71 years old female who was injured by slip and fall show Mayo type IIIb olecranon fracture.

Fig. 6.

Follow-up radiographs taken at 3 years after surgery show bony union with mild osteo-arthritic change of elbow joint.

Fig. 7.

Photographs of the patient taken at 3 years after surgery.

Table 1.

Patient data

Case No.	Age (yr)	Sex	Follow-up (mo)	Union (mo)	ROM (^o)	DASH	MEPS	Complications	Used plate
1	55	M	14	3.5	95	12.4	85	None	VA-LCP+mini-plate
2	71	F	40	3	130	7.5	85	Posttraumatic OA	VA-LCP
3	24	M	19	3	140	11.3	90	None	VA-LCP
4	59	M	16	4	140	24.3	75	None	VA-LCP
5	43	M	24	5	140	15.2	85	None	VA-LCP
6	58	M	26	4	120	18.0	85	None	VA-LCP
7	39	M	13	5	115	16.6	80	None	VA-LCP
8	55	M	18	5	120	18.2	80	None	VA-LCP
9	43	M	20	4	120	17.5	85	None	VA-LCP
10	48	M	19	4	110	13.5	95	None	VA-LCP+mini-plate
11	53	F	16	7	150	19.2	85	None	VA-LCP
12	34	M	14	5	140	5.4	95	None	VA-LCP
13	78	M	13	4	140	6.7	90	None	VA-LCP
14	69	M	13	8	120	9.2	80	None	VA-LCP
15	38	M	17	4	135	8.0	90	None	VA-LCP
16	52	M	13	6	130	7.6	85	None	VA-LCP
17	30	M	14	3	130	12.2	80	None	VA-LCP
18	34	M	16	3	130	6.1	95	None	VA-LCP
19	63	F	13	3	150	3.1	100	None	VA-LCP
20	22	M	18	4	135	8.3	90	None	VA-LCP
21	61	M	16	4	130	7.5	95	None	VA-LCP
22	26	F	16	4	150	6.6	95	None	VA-LCP
23	54	M	14	3	130	7.5	95	None	VA-LCP
24	33	F	13	4	140	6.0	90	None	VA-LCP
25	72	M	19	6.5	120	7.7	95	None	VA-LCP
26	65	M	13	3	135	5.4	95	None	VA-LCP
27	44	M	13	3	120	12.2	90	None	VA-LCP
28	89	M	13	3.5	115	19.5	85	None	VA-LCP
29	56	M	14	3	130	7.5	95	None	VA-LCP
Average	50.6		16.8	4	129.7	11.04	88.6

ROM: range of motion, DASH: disability of the arm, shoulder and hand, MEPS: Mayo elbow performance score, M: male, F: female, OA: osteoarthritis, VA-LCP: variable angle locking compression plate.

TOOLS

Similar articles