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The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures

BACKGROUND: In order to improve initial operative treatment of complex olecranon fractures we searched for new determining details. We assumed that the intermediate fragment plays a decisive role for anatomic restoration of the trochlear notch and consecutive outcome of initial operative treatment....

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Autores principales: von Rüden, Christian, Woltmann, Alexander, Hierholzer, Christian, Trentz, Otmar, Bühren, Volker
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2011
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044106/
https://www.ncbi.nlm.nih.gov/pubmed/21310049
http://dx.doi.org/10.1186/1749-799X-6-9
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author von Rüden, Christian
Woltmann, Alexander
Hierholzer, Christian
Trentz, Otmar
Bühren, Volker
author_facet von Rüden, Christian
Woltmann, Alexander
Hierholzer, Christian
Trentz, Otmar
Bühren, Volker
author_sort von Rüden, Christian
collection PubMed
description BACKGROUND: In order to improve initial operative treatment of complex olecranon fractures we searched for new determining details. We assumed that the intermediate fragment plays a decisive role for anatomic restoration of the trochlear notch and consecutive outcome of initial operative treatment. METHODS: 80 patients operated with diagnosis of complex olecranon fracture were identified in an 8-year-period from trauma unit files at two European Level 1 Trauma Centers. Retrospective review of all operative reports and radiographs/computer-tomography scans identified patients with concomitance of an intermediate fragment. The Patient-Rated Elbow Evaluation Score was calculated for 45 of 80 patients at a minimum of 8 months postoperatively (range 8-84 months). RESULTS: 29 patients were treated with stable internal fixation with figure-of-eight tension band wire fixation and 51 patients with posterior plate osteosynthesis with/without intramedullary screw. An intermediate fragment was seen in 52 patients. In 29 of these 52 patients, the intermediate fragment was described in operative report. 24 of these 29 patients were treated with posterior plate osteosynthesis, and 5 patients with figure-of-eight tension band wiring. Complications included superficial infection (2 patients), secondary dislocation (3 patients) and heterotopic ossifications (1 patient). Functional outcome demonstrated a total PREE score of 9 points on average in 45 of 80 patients. CONCLUSION: An extraordinary amount of patients showed an intermediate fragment. Consideration, desimpaction and anatomic reduction of the intermediate fragment are necessary preconditions for anatomic restoration of the trochlear notch. There is no clear benefit for plating versus tension band wiring according to our data. In the operative report precise description of the fracture pattern including presence of an intermediate fragment is recommended.
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spelling pubmed-30441062011-02-24 The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures von Rüden, Christian Woltmann, Alexander Hierholzer, Christian Trentz, Otmar Bühren, Volker J Orthop Surg Res Research Article BACKGROUND: In order to improve initial operative treatment of complex olecranon fractures we searched for new determining details. We assumed that the intermediate fragment plays a decisive role for anatomic restoration of the trochlear notch and consecutive outcome of initial operative treatment. METHODS: 80 patients operated with diagnosis of complex olecranon fracture were identified in an 8-year-period from trauma unit files at two European Level 1 Trauma Centers. Retrospective review of all operative reports and radiographs/computer-tomography scans identified patients with concomitance of an intermediate fragment. The Patient-Rated Elbow Evaluation Score was calculated for 45 of 80 patients at a minimum of 8 months postoperatively (range 8-84 months). RESULTS: 29 patients were treated with stable internal fixation with figure-of-eight tension band wire fixation and 51 patients with posterior plate osteosynthesis with/without intramedullary screw. An intermediate fragment was seen in 52 patients. In 29 of these 52 patients, the intermediate fragment was described in operative report. 24 of these 29 patients were treated with posterior plate osteosynthesis, and 5 patients with figure-of-eight tension band wiring. Complications included superficial infection (2 patients), secondary dislocation (3 patients) and heterotopic ossifications (1 patient). Functional outcome demonstrated a total PREE score of 9 points on average in 45 of 80 patients. CONCLUSION: An extraordinary amount of patients showed an intermediate fragment. Consideration, desimpaction and anatomic reduction of the intermediate fragment are necessary preconditions for anatomic restoration of the trochlear notch. There is no clear benefit for plating versus tension band wiring according to our data. In the operative report precise description of the fracture pattern including presence of an intermediate fragment is recommended. BioMed Central 2011-02-10 /pmc/articles/PMC3044106/ /pubmed/21310049 http://dx.doi.org/10.1186/1749-799X-6-9 Text en Copyright ©2011 von Rüden et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
von Rüden, Christian
Woltmann, Alexander
Hierholzer, Christian
Trentz, Otmar
Bühren, Volker
The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
title The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
title_full The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
title_fullStr The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
title_full_unstemmed The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
title_short The pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
title_sort pivotal role of the intermediate fragment in initial operative treatment of olecranon fractures
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044106/
https://www.ncbi.nlm.nih.gov/pubmed/21310049
http://dx.doi.org/10.1186/1749-799X-6-9
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