Tension plate for treatment of olecranon fractures: new surgical technique and case series study

• Published in: Canadian Journal of Surgery 2015-02, Vol.58 (1), p.24-30
• Main Authors: Lukšic, Bruno, MD, Juric, Ivo, MD, PhD, Boschi, Vladimir, MD, PhD, Pogorelic, Zenon, MD, PhD, Bekavac, Josip, MD
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Bone Plates; Case-Control Studies; Device Removal - statistics & numerical data; Elbow; Equipment and supplies; Female; Follow-Up Studies; Fracture fixation; Fracture Fixation, Internal - instrumentation; Fracture Fixation, Internal - methods; Fractures; Humans; Injuries; Male; Medical treatment; Methods; Middle Aged; Olecranon Process - injuries; Patient Outcome Assessment; Patient outcomes; Prosthesis Design; Range of Motion, Articular; Surgery; Surgical techniques; Ulna Fractures - surgery; Young Adult
• ISSN: 0008-428X; 1488-2310
• DOI: 10.1503/cjs.030313

Background Our aim was to determine the effectiveness of a new surgical technique for olecranon fractures using a tension plate (TP) designed by the operating surgeon. Methods We included patients with olecranon fractures treated between September 2010 and August 2013 in our study. Treatment involved a new implant and operative technique, which combined the most favourable characteristics of 2 frequently used methods, tension band wiring and plate osteosynthesis, while eliminating their shortcomings. The new method was based on the newly constructed implant. Results Twenty patients participated in our study. We obtained the following functional results with our TP: median flexion 147.5° (interquartile range [IQR] 130°–155°), median extension 135°/deficit 10° (IQR 135°–145°), median pronation 90° (IQR 81.3°–90°), median supination 90° (IQR 80°–90°). Implant-related complications were noted in 1 patient, and implants were removed in 3 patients. The mean functional Mayo elbow performance score was 94.8 (range 65–100). The removal of the implant was considerably less frequent in patients operated using the new method and implant than in patients operated using conventional methods at our institution ( p &spilt; 0.001). Mean duration of follow-up was 8 months. Conclusion Our TP for the treatment of olecranon fractures is safe and effective. Functional results are very good, with significantly decreased postoperative inconveniences and need to remove the implant. Less osteosynthetic material was used for TP construction, but stability was preserved.