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Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients

INTRODUCTION: Tension band wiring of olecranon fractures has high reported rates of complications and reoperations. We aimed to compare classic tension band wiring to cerclage fixation without K-wires in the treatment of displaced olecranon fractures in elderly patients. The primary outcome was reop...

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Autores principales: Wenger, Daniel, Cornefjord, Gustav, Rogmark, Cecilia
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9474339/
https://www.ncbi.nlm.nih.gov/pubmed/34236459
http://dx.doi.org/10.1007/s00402-021-04027-3
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author Wenger, Daniel
Cornefjord, Gustav
Rogmark, Cecilia
author_facet Wenger, Daniel
Cornefjord, Gustav
Rogmark, Cecilia
author_sort Wenger, Daniel
collection PubMed
description INTRODUCTION: Tension band wiring of olecranon fractures has high reported rates of complications and reoperations. We aimed to compare classic tension band wiring to cerclage fixation without K-wires in the treatment of displaced olecranon fractures in elderly patients. The primary outcome was reoperation. Secondary outcomes included complications and patient reported outcomes. Outcomes following non-operative treatment were also studied. MATERIALS AND METHODS: Patients aged > 69 years presenting with Mayo class 2a and 2b olecranon fractures at our institution from 2004 through 2016 (n = 239) were eligible for study. Fracture type, treatment method, complications and reoperations were assessed from radiographs and hospital files. QuickDASH surveys were collected by mail. RESULTS: Patients operated with tension band wire technique had more reoperations (p value 0.03): relative risk (RR) 2.2 (CI 1.08–4.3), odds ratio (OR) 2.6 (CI 1.05–6.4), and complications (p value 0.001): RR 2.5 (CI 1.51–4.1), OR 3.7 (CI 1.67–8.2), compared with those operated with cerclage technique. Non-operative treatment yielded similar complication (p value 0.2) and reoperation rates (p value 0.06) as cerclage fixation. The answer rate was insufficient to compare QuickDASH scores between treatments methods. CONCLUSIONS: In patients 70 years and older undergoing cerclage fixation for displaced stable olecranon fractures (Mayo class 2), the reoperation and complications rates were less than half of those in patients undergoing TBW fixation. Non-operative treatment yielded similar reoperation and complication rates to cerclage fixation, in selected cases. LEVEL OF EVIDENCE: III—retrospective comparative cohort study.
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spelling pubmed-94743392022-09-16 Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients Wenger, Daniel Cornefjord, Gustav Rogmark, Cecilia Arch Orthop Trauma Surg Trauma Surgery INTRODUCTION: Tension band wiring of olecranon fractures has high reported rates of complications and reoperations. We aimed to compare classic tension band wiring to cerclage fixation without K-wires in the treatment of displaced olecranon fractures in elderly patients. The primary outcome was reoperation. Secondary outcomes included complications and patient reported outcomes. Outcomes following non-operative treatment were also studied. MATERIALS AND METHODS: Patients aged > 69 years presenting with Mayo class 2a and 2b olecranon fractures at our institution from 2004 through 2016 (n = 239) were eligible for study. Fracture type, treatment method, complications and reoperations were assessed from radiographs and hospital files. QuickDASH surveys were collected by mail. RESULTS: Patients operated with tension band wire technique had more reoperations (p value 0.03): relative risk (RR) 2.2 (CI 1.08–4.3), odds ratio (OR) 2.6 (CI 1.05–6.4), and complications (p value 0.001): RR 2.5 (CI 1.51–4.1), OR 3.7 (CI 1.67–8.2), compared with those operated with cerclage technique. Non-operative treatment yielded similar complication (p value 0.2) and reoperation rates (p value 0.06) as cerclage fixation. The answer rate was insufficient to compare QuickDASH scores between treatments methods. CONCLUSIONS: In patients 70 years and older undergoing cerclage fixation for displaced stable olecranon fractures (Mayo class 2), the reoperation and complications rates were less than half of those in patients undergoing TBW fixation. Non-operative treatment yielded similar reoperation and complication rates to cerclage fixation, in selected cases. LEVEL OF EVIDENCE: III—retrospective comparative cohort study. Springer Berlin Heidelberg 2021-07-08 2022 /pmc/articles/PMC9474339/ /pubmed/34236459 http://dx.doi.org/10.1007/s00402-021-04027-3 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Trauma Surgery
Wenger, Daniel
Cornefjord, Gustav
Rogmark, Cecilia
Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
title Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
title_full Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
title_fullStr Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
title_full_unstemmed Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
title_short Cerclage fixation without K-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
title_sort cerclage fixation without k-wires is associated with fewer complications and reoperations compared with tension band wiring in stable displaced olecranon fractures in elderly patients
topic Trauma Surgery
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9474339/
https://www.ncbi.nlm.nih.gov/pubmed/34236459
http://dx.doi.org/10.1007/s00402-021-04027-3
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