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Intramedullary screw fixation for simple displaced olecranon fractures

PURPOSE: Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of...

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Autores principales: Bosman, Willem-Maarten P. F., Emmink, Benjamin L., Bhashyam, Abhiram R., Houwert, R. Marijn, Keizer, Jort
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026218/
https://www.ncbi.nlm.nih.gov/pubmed/30879100
http://dx.doi.org/10.1007/s00068-019-01114-4
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author Bosman, Willem-Maarten P. F.
Emmink, Benjamin L.
Bhashyam, Abhiram R.
Houwert, R. Marijn
Keizer, Jort
author_facet Bosman, Willem-Maarten P. F.
Emmink, Benjamin L.
Bhashyam, Abhiram R.
Houwert, R. Marijn
Keizer, Jort
author_sort Bosman, Willem-Maarten P. F.
collection PubMed
description PURPOSE: Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. METHODS: We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). RESULTS: By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. CONCLUSIONS: Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.
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spelling pubmed-70262182020-03-02 Intramedullary screw fixation for simple displaced olecranon fractures Bosman, Willem-Maarten P. F. Emmink, Benjamin L. Bhashyam, Abhiram R. Houwert, R. Marijn Keizer, Jort Eur J Trauma Emerg Surg Original Article PURPOSE: Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. METHODS: We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). RESULTS: By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. CONCLUSIONS: Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation. Springer Berlin Heidelberg 2019-03-16 2020 /pmc/articles/PMC7026218/ /pubmed/30879100 http://dx.doi.org/10.1007/s00068-019-01114-4 Text en © The Author(s) 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Article
Bosman, Willem-Maarten P. F.
Emmink, Benjamin L.
Bhashyam, Abhiram R.
Houwert, R. Marijn
Keizer, Jort
Intramedullary screw fixation for simple displaced olecranon fractures
title Intramedullary screw fixation for simple displaced olecranon fractures
title_full Intramedullary screw fixation for simple displaced olecranon fractures
title_fullStr Intramedullary screw fixation for simple displaced olecranon fractures
title_full_unstemmed Intramedullary screw fixation for simple displaced olecranon fractures
title_short Intramedullary screw fixation for simple displaced olecranon fractures
title_sort intramedullary screw fixation for simple displaced olecranon fractures
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7026218/
https://www.ncbi.nlm.nih.gov/pubmed/30879100
http://dx.doi.org/10.1007/s00068-019-01114-4
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