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Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique

INTRODUCTION: External fixator application can be difficult for olecranon fractures in presence of large degloving injuries. We describe use of simple Ilizarov ring fixator construct for grade IIIB open olecranon fracture management. CASE REPORT: A 45-year-old female with Grade III B open comminuted...

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Autores principales: Sharad Nemade, Pradip, Dash, Kumar Kaushik, Patwardhan, Tanvi Yeshwant, Londhe, Pravin Vasant
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Indian Orthopaedic Research Group 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719344/
https://www.ncbi.nlm.nih.gov/pubmed/27299012
http://dx.doi.org/10.13107/jocr.2250-0685.246
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author Sharad Nemade, Pradip
Dash, Kumar Kaushik
Patwardhan, Tanvi Yeshwant
Londhe, Pravin Vasant
author_facet Sharad Nemade, Pradip
Dash, Kumar Kaushik
Patwardhan, Tanvi Yeshwant
Londhe, Pravin Vasant
author_sort Sharad Nemade, Pradip
collection PubMed
description INTRODUCTION: External fixator application can be difficult for olecranon fractures in presence of large degloving injuries. We describe use of simple Ilizarov ring fixator construct for grade IIIB open olecranon fracture management. CASE REPORT: A 45-year-old female with Grade III B open comminuted olecranon fracture (30*15cm degloving area) and ulnar nerve palsy was treated with a novel ring fixator construct. Two cut-end olive wires were passed from the proximal olecranon across the fracture site in intramedullary fashion exiting dorsally at mid-ulnar level through healthy skin and were attached to an Ilizarov half ring secured by perpendicular wires. The olive wires were tensioned, achieving compression and stability. Range of motion (ROM) exercises could be started quickly as the elbow was not spanned. Wound healed after skin grafting and at one-year follow-up the patient has good functional results (PRE 7, DASH 9.48), elbow ROM 10°-130°, 75° pronation and 85° supination. The patient returned to pre-injury occupational activities and had no pain. At three-year follow-up, the x-ray and CT showed union of olecranon fragment with well-maintained congruency. CONCLUSION: Internal fixation in most cases may be precluded by the soft tissue trauma and risk of infection. In addition, the small proximal fragment precludes a stable external fixation. In this technique, the hardware is kept away from the open wound allowing better wound inspection and care. The intramedullary olive wires provide compression and stability, and thus allow early ROM. Ilizarov half-ring and olive wire fixation can be an useful option for management of high grade open olecranon fractures because of its advantages, viz. stable fixation, minimal internal hardware, optimal wound care, immediate initiation of range of motion, and good outcome.
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spelling pubmed-47193442016-06-13 Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique Sharad Nemade, Pradip Dash, Kumar Kaushik Patwardhan, Tanvi Yeshwant Londhe, Pravin Vasant J Orthop Case Rep Case Report INTRODUCTION: External fixator application can be difficult for olecranon fractures in presence of large degloving injuries. We describe use of simple Ilizarov ring fixator construct for grade IIIB open olecranon fracture management. CASE REPORT: A 45-year-old female with Grade III B open comminuted olecranon fracture (30*15cm degloving area) and ulnar nerve palsy was treated with a novel ring fixator construct. Two cut-end olive wires were passed from the proximal olecranon across the fracture site in intramedullary fashion exiting dorsally at mid-ulnar level through healthy skin and were attached to an Ilizarov half ring secured by perpendicular wires. The olive wires were tensioned, achieving compression and stability. Range of motion (ROM) exercises could be started quickly as the elbow was not spanned. Wound healed after skin grafting and at one-year follow-up the patient has good functional results (PRE 7, DASH 9.48), elbow ROM 10°-130°, 75° pronation and 85° supination. The patient returned to pre-injury occupational activities and had no pain. At three-year follow-up, the x-ray and CT showed union of olecranon fragment with well-maintained congruency. CONCLUSION: Internal fixation in most cases may be precluded by the soft tissue trauma and risk of infection. In addition, the small proximal fragment precludes a stable external fixation. In this technique, the hardware is kept away from the open wound allowing better wound inspection and care. The intramedullary olive wires provide compression and stability, and thus allow early ROM. Ilizarov half-ring and olive wire fixation can be an useful option for management of high grade open olecranon fractures because of its advantages, viz. stable fixation, minimal internal hardware, optimal wound care, immediate initiation of range of motion, and good outcome. Indian Orthopaedic Research Group 2015 /pmc/articles/PMC4719344/ /pubmed/27299012 http://dx.doi.org/10.13107/jocr.2250-0685.246 Text en Copyright: © Indian Orthopaedic Research Group http://creativecommons.org/licenses/by-nc-sa/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc-sa/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Sharad Nemade, Pradip
Dash, Kumar Kaushik
Patwardhan, Tanvi Yeshwant
Londhe, Pravin Vasant
Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique
title Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique
title_full Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique
title_fullStr Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique
title_full_unstemmed Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique
title_short Use of Ilizarov Fixator for Grade III B Open Olecranon Fracture: a Case Report and Surgical Technique
title_sort use of ilizarov fixator for grade iii b open olecranon fracture: a case report and surgical technique
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4719344/
https://www.ncbi.nlm.nih.gov/pubmed/27299012
http://dx.doi.org/10.13107/jocr.2250-0685.246
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