1/17/2024 0 Comments Olecranon fracture orthobullets![]() ![]() incidence of fracture-related infection range from <1 in type I open fractures to 30 in type III fractures. infection rates of open fracture depend on zone of injury, periosteal stripping and delay in treatment. ![]() Extremely rarely it can mimic a patella cubiti. ideal time of soft tissue coverage controversial, but most centers perform within 5-7 days. In young patients, one must consider unfused olecranon epiphysis 3. There is usually little differential, especially in adults, and when the clinical presentation is that of trauma to the elbow with pain, swelling and lack of mobility. Occasionally ulnar nerve injury can result in long-term sensory and motor impairment, most marked in the hand. Most of the symptoms relate to prominence of hardware given the little overlying soft tissues 1. Unlike many other intra-articular fractures, olecranon fractures result in relatively little secondary osteoarthritic changes, probably on account of most fractures occurring through a relatively non-articular part of the trochlear groove 1. Union rates with appropriate treatment are very high (~99%) and other than a slight reduction in flexion and extension at the elbow, function is preserved 1,2. Non-operative treatment can be considered for undisplaced fractures or patients with significant medical co-morbidities 2. Presence of fracture of the distal humerusĭue to the unopposed traction of the triceps muscle, these fractures are usually widely displaced and require open reduction and internal fixation (ORIF) 1. Presence of fracture or dislocation of the radial head Presence of fracture of the coronoid process Location, especially whether or not it reaches the articular surfaceĪssociated findings and relevant negatives Radiology reports should not only include whether or not a fracture is present but also comment on: They appear as a lucency usually reaching the trochlear groove articular surface and are, in most cases, displaced. Olecranon fractures are easy to diagnose provided a lateral x-ray of the elbow is obtained. It is important to remember that the ulnar nerve is closely related to the medial aspect of the olecranon and, although not common, nerve injury may complicate these fractures 2. Several novel methods of olecranon fixation may represent viable alternatives.Olecranon fractures occur as the result of one of four mechanisms 2:ĭirect blow (or fall directly on the elbow)įall on outstretched hand with elbow flexedĪvulsion fracture - e.g. This meta-analysis revealed significantly lower complication and hardware removal rates for PF compared with TBW. Qualitative analysis revealed novel methods of olecranon fixation: a modified cable pin system, tension banding through 2 cannulated screws, olecranon memory connector fixation, and cancellous screw TBW. Subgroup analyses showed no difference when comparing randomized controlled trials with observational studies for the outcomes of complication rate (P=.45) and hardware removal (P=.54). Plate fixation (41 of 332) also had less hardware removal compared with TBW (79 of 236 relative risk, 0.36 95% confidence interval, 0.25-0.50 P<. Compared with TBW (n=270), patients who underwent PF (n=369) had a significantly lower complication rate (relative risk, 0.48 95% confidence interval, 0.36-0.64 P<. Twenty-four studies were included in the systematic review and 10 studies were included in the meta-analysis of TBW vs PF. In addition, the authors evaluated novel fixation techniques other than TBW and PF. ![]() Subgroup analyses were conducted comparing randomized controlled trials with observational studies for each outcome. The authors compared tension-band wiring (TBW) with plate fixation (PF) for the outcomes of complications and hardware removal. Two investigators independently screened articles from records obtained from MEDLINE, Embase, SPORTDiscus, CINAHL, and the Cochrane Library databases. The authors conducted a systematic review and meta-analysis to evaluate surgical management strategies for olecranon fractures in adult patients. Olecranon fractures are common upper-extremity fractures amenable to various surgical techniques.
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