Olecranon Fractures - Simon Coleridge 30/1/2001

Olecranon Fractures

o Internal fixation since 1883, allowing early active movement.

o Classification: Mayo types I-III, for the olecranon and Bado Types I-IV in the case of the Monteggia fracture.

o Mayo Type I fractures are generally treated conservatively. While type II, the classic fracture pattern, is normally ORIF. Classically type II fractures are treated with tension band wires and type III with plate fixation.

o Monteggia (Giovanni Monteggia 1814) fractures in adults and children should be treated separately as management and outcome is very different.

o Good review article by Morrey JBJS 1995; 77A (2):317-327

Brief

HUME Clinical Orthopaedics 1992

Author

Mary C Hume (Southern California Medical Centre)

Title

Olecranon Fractures a Clinical and Radiological Comparison of Tension Band Wiring and Plate Fixation

Reference

Clin Orth 1992; 285:229-235

Summary

Best paper in the literature at comparing the AO tension band wiring with plate fixation, looking at complications, functional outcome and radiological appearance.

Critique

Retrospective paper well conducted. Only 41 patients. Concluded, despite slightly longer op time, with plate fixation, there was less complication from metalwork, the position was more anatomical, the ROM and patient satisfaction was better with the plate. They did take into account the different fracture patterns, and it seemed tension band wiring was being used for comminuted fractures!?



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