Outcome of olecranon osteotomy in the trans-olecranon approach of intra-articular fractures of the distal humerus.
BACKGROUND: The trans-olecranon approach has been suggested to improve the visualization of complex intra-articular distal humerus fractures. Significant osteotomy complications have prompted a search for alternative approaches. The purpose of this series was to study the outcome of the olecranon osteotomy in terms of union and complications and the ultimate outcome of the fracture. METHODS: Ninety-four patients with intra-articular fractures of the distal humerus (type C3) were treated by open reduction and internal fixation using the trans-olecranon approach. The patients were followed from 6 to 48 months, with an average follow-up of 24 months. RESULTS: All osteotomies united in an average of 11 weeks (range, 8-20 weeks). There was no non-union, although union was delayed in four osteotomies, which all healed by 20 weeks without any intervention. The most frequent complication in this study was symptomatic osteotomy fixation in 19% of patients, all of whom underwent a secondary procedure for the removal of the implant after the osteotomy had united. Seventy-one percent of the unsatisfactory results were seen in those patients who had symptomatic olecranon fixation. CONCLUSION: Despite a few manageable complications, the trans-olecranon approach is essential for the adequate visualization and fixation of the complex fracture of the distal humerus. Adequate fixation of the osteotomy is essential to prevent complications and achieve a satisfactory outcome. (+info)
Infectious olecranon and patellar bursitis: short-course adjuvant antibiotic therapy is not a risk factor for recurrence in adult hospitalized patients.
Plate osteosynthesis for severe olecranon fractures.
PURPOSE: To review outcomes of 10 patients who underwent plate osteosynthesis for severe olecranon fractures. METHODS: Records of 7 men and 3 women aged 33 to 73 years who underwent plate osteosynthesis for severe olecranon fractures were reviewed. All had some degree of soft-tissue injury; 6 presented with associated fractures. Seven patients were treated with a limited contact dynamic compression plate, and the remaining 3 received a locking compression plate. Patients were followed up for fracture healing, range of motion, nerve damage, heterotopic ossification, infection, hardware complaints, and the need of a secondary surgical procedure. The Mayo Elbow Performance Score (MEPS) was determined at the final follow-up. The patient-answered questionnaire (PAQ) portion of the Liverpool Elbow Score (LES) was evaluated 2 to 37 months later by telephone. RESULTS: All patients had bone union. None had nerve damage or heterotopic ossification. Patients 4, 6, and 8 with type-IIIB fractures developed deep infections and severe soft-tissue swelling; all had been treated with the limited contact dynamic compression plate. Four patients underwent plate removal owing to hardware complaints. One patient underwent a secondary procedure to restore complete range of elbow motion. The mean MEPS score was 84 (range, 35-100); 5 patients attained excellent scores, one good, 2 satisfactory, and 2 unsatisfactory. The mean PAQ portion of the LES score was 31 (range, 23-36). CONCLUSION: Plate osteosynthesis achieves satisfactory results for severe olecranon fractures. The deep infection rate is higher in patients with severe soft-tissue injury. (+info)
Bilateral olecranon epiphyseal fracture non-union in a competitive athlete.
Olecranon epiphyseal stress fractures and epiphyseal non-unions have been described in throwing athletes, weight lifters and gymnasts. We present a case in which bilateral olecranon epiphyseal fractures were diagnosed in a competitive NCAA Division One wrestler who presented with chronic elbow pain. Given the rigors and physical demands of collegiate wrestling, we present a novel technique for open reduction internal fixation, grafting and supplementation with BMP for accelerated healing and return to competition. (+info)
The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures.