Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications
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ORIGINAL PAPER
Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications Juan Martín Patiño 1
&
Alejandro F. Rullan Corna 1 & Alejandro E. Michelini 1 & Ignacio M. Abdon 1 & Bruno Marinucci 1
Received: 8 May 2020 / Accepted: 29 June 2020 # SICOT aisbl 2020
Abstract Purpose To report radiologic, functional outcomes, and complications with a long-term follow-up in acute olecranon fractures treated with osteosynthesis and, secondly, to determine the predisposing factors to arthritis. Methods Forty-two patients treated with osteosynthesis for acute olecranon fractures were reviewed, with a minimum follow-up of 24 months. Radiological and clinical evaluations including DASH, MEPS, active range of motion, pain, arthritis, associated lesions, and complications were recorded. Arthritis was classified according to Broberg-Morrey scale. A logistic regression model was estimated to determine risk factors to develop ulnohumeral arthritis. The association between the types of fractures according to Mayo classification and MEPS, and the association between the type of fracture and the presence of pain were analyzed. Results The average follow-up was of 43.64 months. The flexion-extension average range was 135.6°, and the mean MEPS was 89.45; the DASH was 25.26. Eighteen cases (42.86%) were fixed with pre-contoured locking plates, 21 with tension band wiring (50%), and 3 with cannulated screws of 7 mm (7.14%). Six cases (14.29%) needed hardware removal. All fractures healed. Ulnohumeral osteoarthritis was observed in 14 cases (33.3%). We did not find a significant association among the MEPS, pain, and the fracture type, according to Mayo (p > 0.1 for both values). A significant association was found (p < 0.05) between fracture type and the osteoarthritis. Conclusions In olecranon fractures, good functional and radiological results with low complications are predictable. The osteoarthritis is possible in more complex fractures and with other associated fractures. Keywords Olecranon fractures . Elbow osteoarthritis . Osteoarthritis . Open reduction . Osteosynthesis
Introduction Olecranon articular fractures are the most frequent fractures in the elbow. The different options of osteosynthesis have been associated with good functional results, but with a high number of a second surgery [1–3]. There are reports and evidence focused on
All contributing authors perform their activity in Hospital Militar Central, Cirujano Mayor Cosme Argerich, Buenos Aires, Argentina, Departamento de Ortopedia y Traumatología, Sección de hombro y codo, Servicio de Cirugía de la Mano y miembro superior * Juan Martín Patiño [email protected] 1
Sección de Hombro y Codo, Servicio de Cirugía de la Mano y miembro superior, Departamento de Ortopedia y Traumatología, Hospital Militar Central. Cirujano Mayor Cosme Argerich, Luis Maria Campos Av. 726 piso 6, C1426BOS Buenos Aires City, Argentina
the results with different osteosynthesis methods used. Other publications evaluated the results in fractures-dislocations [4].
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