Intramedullary screw fixation for simple displaced olecranon fractures

Abstract

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.

Fixation of olecranon osteotomy only with 6′5 mm partially trheaded cancellous screw is a safe an effective method used in surgical management of distal humerus fractures

“…Moreover, Bosman in 2020 [3] used 7′3 mm intramedullary screw fixation for simple, displaced fractures in 15 patients with excellent results. They used screws of enough length to engage the narrow marrow of the proximal ulnar diaphysis (typically 90-110) to get a stable fixation.…”

Long-term outcomes after different types of Horne and Tanzer olecranon fractures

“…This corresponds to an incidence of 1.15/10,000 person-years [1][2][3]. The short and medium term outcome of these fractures is generally reported as good [4][5][6][7][8][9][10][11][12][13][14], and the few existing long-term studies, one of which followed olecranon fractures for more than 10 years [15] and another for more than 15 years [2], support a durable outcome with time. No study has to our knowledge evaluated if the favorable long-term outcome accounts for all subtypes of olecranon fractures.…”

“…No study has to our knowledge evaluated if the favorable long-term outcome accounts for all subtypes of olecranon fractures. Most shortterm studies have only evaluated if the outcome differs after different type of surgeries [4][5][6][7][8][9][10][11][12][13][14]. On such study inferred that type of surgery are of more importance for the outcome than type of fracture [16], another study supporting this view when reporting no differences when comparing 78 consecutive patients with Mayo type IIA and IIB fractures [17].…”

Short-term Outcomes of Herbert Screw Fixation for Isolated Olecranon Fractures in Children: a Single-institution Retrospective Study

“…Furthermore, the open reduction and extensive exposure increases the risk for ischemic insult of the growth plate [9]. In 1942, MacAusland described the treatment of olecranon fractures by intramedullary screw xation, but subsequent reports noted that the technique was challenging and unreliable [10][11]. Persiani et al reported the outcomes of treatment of olecranon fractures in children affected with osteogenesis imperfecta (OI) type I by screw xation.…”