Article

Management of comminuted olecranon fractures with precut K-wires and tension band wiring.

Department of Orthopaedics, Ibri Regional Referral Hospital, Ibri, Sultanate of Oman.
Techniques in hand & upper extremity surgery 07/2009; 13(2):82-4. DOI: 10.1097/BTH.0b013e31819225dc
Source: PubMed

ABSTRACT Various methods are used to treat comminuted fractures of the olecranon. The preferred method of management of fractures of the olecranon is tension band wiring over K-wires. Often, it becomes difficult to fix small articular fragments with the 2 K-wires used for tension band wiring. Since 2005, we have used the missing K-wire technique to fix the small articular fragments.

0 Followers
 · 
102 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: Various methods are used to treat comminuted fractures of the olecranon. The preferred method of management of fractures of the olecranon is tension band wiring over K-wires. Often, it becomes difficult to fix small articular fragments with the 2 K-wires used for tension band wiring. Since 2005, we have used the missing K-wire technique to fix the small articular fragments.
    Techniques in hand & upper extremity surgery 07/2009; 13(2):82-4. DOI:10.1097/BTH.0b013e31819225dc
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: In order to improve initial operative treatment of complex olecranon fractures we searched for new determining details. We assumed that the intermediate fragment plays a decisive role for anatomic restoration of the trochlear notch and consecutive outcome of initial operative treatment. 80 patients operated with diagnosis of complex olecranon fracture were identified in an 8-year-period from trauma unit files at two European Level 1 Trauma Centers. Retrospective review of all operative reports and radiographs/computer-tomography scans identified patients with concomitance of an intermediate fragment. The Patient-Rated Elbow Evaluation Score was calculated for 45 of 80 patients at a minimum of 8 months postoperatively (range 8-84 months). 29 patients were treated with stable internal fixation with figure-of-eight tension band wire fixation and 51 patients with posterior plate osteosynthesis with/without intramedullary screw. An intermediate fragment was seen in 52 patients. In 29 of these 52 patients, the intermediate fragment was described in operative report. 24 of these 29 patients were treated with posterior plate osteosynthesis, and 5 patients with figure-of-eight tension band wiring. Complications included superficial infection (2 patients), secondary dislocation (3 patients) and heterotopic ossifications (1 patient). Functional outcome demonstrated a total PREE score of 9 points on average in 45 of 80 patients. An extraordinary amount of patients showed an intermediate fragment. Consideration, desimpaction and anatomic reduction of the intermediate fragment are necessary preconditions for anatomic restoration of the trochlear notch. There is no clear benefit for plating versus tension band wiring according to our data. In the operative report precise description of the fracture pattern including presence of an intermediate fragment is recommended.
    Journal of Orthopaedic Surgery and Research 02/2011; 6:9. DOI:10.1186/1749-799X-6-9 · 1.58 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: BACKGROUND: Our objective was to determine surgeon- and patient-based perceptions concerning proximal ulna fixation, including rates of implant removal and overall satisfaction. METHODS: Orthopedic surgeons were surveyed about surgical experience managing proximal ulna fractures and their perception regarding implant removal/revision. A retrospective chart review identified all patients who underwent fixation for proximal ulna fractures and osteotomies between January 2004 and December 2008. RESULTS: In total, 583 surgeons responded to the survey (80%). Of these, 67% believed that their implant removal rate was the same as other surgeons whereas 31% believed that their rate was lower. Seventy-one percent believed that patients required hardware removal less than 30% of the time. Ninety-eight percent believed that they were the same surgeons to remove the implant. In total, 138 consecutive patients were surveyed about their proximal ulna implant. Plating was performed in 80 (58%), and tension banding was performed in 55 (40%). The overall rate of implant removal was 64.5% (89 of 138) at 18.8 months. A second surgeon performed the removal in 68 patients (76%). Of the 49 patients without implant removal, 11 (22%) reported satisfaction with the implant and 19 (39%) reported a functional impairment because of the implant. If guaranteed a safe surgery, 36 (73%) would have the implant removed. CONCLUSION: Surgeons underestimate the rates of proximal ulna implant removal and patient dissatisfaction. Because 76% of the implant removals were performed by a second surgeon, in sharp contrast to the surgeon-perceived rate of 2%, we challenge surgeons to become more aware of this problem in their practices.
    Journal of shoulder and elbow surgery / American Shoulder and Elbow Surgeons ... [et al.] 03/2012; 21(12). DOI:10.1016/j.jse.2011.11.024 · 2.37 Impact Factor
Show more