DOI: http://dx.doi.org/10.18203/issn.2455-4510.IntJResOrthop20213382

Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation

Neetin P. Mahajan, Mrugank A. Narvekar, Lalkar L. Gadod, G. S. Prasanna Kumar

Abstract


Background: A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.

Methods: The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.

Results: The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.

Conclusions: In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.


Keywords


Olecranon fracture, Locking compression plate, Conventional plate

Full Text:

PDF

References


Egol K, Koval K, Zuckerman J. Handbook of fractures. 5th ed. Philadelphia, PA: Wolters Kluwer Health; 2015.

Duckworth AD, Clement ND, Aitken SA, Brown CM, McQueen MM. The epidemiology of fractures of the proximal ulna. Injury. 2012;43(3):343-6.

Wild JR, Askam BM, Margolis DS, Geffre CP, Krupinski EA, Truchan LM. Biomechanical evaluation of suture-augmented locking plate fixation for proximal third fractures of the olecranon. J Orthop Trauma. 2012;26(9):533-8.

Fantry A, Sobel A, Capito N, Hodax JD, Pidgeon T, Koruprolu S, Rich R, et al. Biomechanical Assessment of Locking Plate Fixation of Comminuted Proximal Olecranon Fractures. J Orthop Trauma. 2018;32(11):445-50.

Brolin TJ, Throckmorton T. Olecranon Fractures. Hand Clin. 2015;31(4):581-90.

Azar FS, Canale T, Beaty J. Campbell's Operative Orthopaedics. 13th ed. Philadelphia, PA: Elsevier; 2017.

Brown C, Heckman J, Mcqueen M, Ricci W, Tornetta P, Mckee M. Rockwood and Green's fractures in adults Vol 1. Philadelphia, PA: Wolters Kluwer; 2015.

Powell AJ, Alanie OM, Bryceland JK, Nunn T. The treatment of olecranon fractures in adults. Musculoskelet Surg. 2017;101(1):1-9.

Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am. 2008;39(2):229-36.

Rommens PM, Küchle R, Schneider RU, Reuter M. Olecranon fractures in adults: factors influencing outcome. Injury. 2004;35(11):1149-57.

Huang TW, Wu CC, Fan KF, Tseng IC, Lee PC, Chou YC. Tension band wiring for olecranon fractures: relative stability of Kirschner wires in various configurations. J Trauma. 2010;68(1):173-6.

Sahajpal D, Wright TW. Proximal ulna fractures. J Hand Surg Am. 2009;34(2):357-62.

Fyfe IS, Mossad MM, Holdsworth BJ. Methods of fixation of olecranon fractures. An experimental mechanical study. J Bone Joint Surg Br. 1985;67(3):367-72.

Hak DJ, Golladay GJ. Olecranon fractures: treatment options. J Am Acad Orthop Surg. 2000;8(4):266-75.

Horner SR, Sadasivan KK, Lipka JM, Saha S. Analysis of mechanical factors affecting fixation of olecranon fractures. Orthopedics. 1989;12(11):1469-72.

Buijze GA, Blankevoort L, Tuijthof GJ, Sierevelt IN, Kloen P. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg. 2010;130(4):459-64.

Puchwein P, Schildhauer TA, Schöffmann S, Heidari N, Windisch G, Pichler W. Three-dimensional morphometry of the proximal ulna: a comparison to currently used anatomically preshaped ulna plates. J Shoulder Elbow Surg. 2012;21(8):1018-23.

Niglis L, Bonnomet F, Schenck B, Brinkert D, Marco A, Adam P, Ehlinger M. Critical analysis of olecranon fracture management by pre-contoured locking plates. Orthop Traumatol Surg Res. 2015;101(2):201-7.

Lan TY, Chen CY, Liao PF, Chen WC, Wu K, Pao JL, et al. Comminuted olecranon fractures treated with anatomically preshaped locking and nonlocking plates: A retrospective comparative study. Formosan J Musculoskel Disord. 2013;4(1):1-5.

Bailey CS, Dermid J, Patterson SD, King GJ. Outcome of plate fixation of olecranon fractures. J Orthop Trauma. 2001;15(8):542-8.

Buijze G, Kloen P. Clinical evaluation of locking compression plate fixation for comminuted olecranon fractures. J Bone Joint Surg Am. 2009;91(10):2416-20.

Mahamud E, Valencia JA, Riba J. Plate osteosynthesis for severe olecranon fractures. J Orthop Surg. 2010;18(1):80-4.

Siebenlist S, Torsiglieri T, Kraus T, Burghardt RD, Stöckle U, Lucke M. Comminuted fractures of the proximal ulna--Preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury. 2010;41(12):1306-11.