A Simple and Safe Technique of Olecranon Osteotomy
- PDF / 1,501,186 Bytes
- 6 Pages / 595.276 x 790.866 pts Page_size
- 54 Downloads / 158 Views
SURGICAL TECHNIQUE
A Simple and Safe Technique of Olecranon Osteotomy Somasekhara Reddy Nallamilli1 · Rajyalakshmi N. Reddy2 · Mohan Krishna Althuri2 Received: 8 July 2020 / Accepted: 24 October 2020 © Indian Orthopaedics Association 2020
Abstract Chevron osteotomy of the olecranon during the posterior approach of the elbow joint has become universally common. We modified the technique to see if it is better than the standard technique to perform, reconstruct and finally evaluate the results. A prospective study was done in 17 cases of comminuted distal humeral intercondylar fractures. A modified osteotomy was done using a Gigli saw instead of a power saw. The indications remained the same. After fixing the distal humerus fracture, the olecranon fragment was stabilised with tension band wire technique. The post-operative management was similar to that of standard AO technique. There were no per-operative difficulties with the new technique. The osteotomy was easy to do with no risk of damage to the distal humeral cartilage, as the direction of the osteotomy was away from the joint. Gigli saw produced congruent antero-posterior chevron surfaces which helped the fragment to sit well in its trough with good bony apposition. Stable reduction of the olecranon facilitated easy fixation. In this series, all osteotomies united well. There were no osteotomy-related complications. Two cases had prominent wires which were removed after the union of the osteotomy. We feel that this osteotomy is easy to perform, safe and takes less time than the standard technique, though a comparative study in a large number of cases by different surgeons needs to confirm the benefits. Keywords Olecranon chevron osteotomy · Tension band wiring of olecranon · Distal humeral fractures · Modified chevron osteotomy of olecranon · Olecranon osteotomy with gigli saw
Introduction Olecranon osteotomy is a well-established technique during the posterior approach of the elbow joint. Though ‘nonarticular’ olecranon osteotomies are commonly used for non-articular fractures of the distal humerus, ‘trans articular’ osteotomy makes fixation of condylar and intercondylar fractures of the humerus, much easier [1–3]. There is a small bare area on the articular side of the olecranon through which osteotomy is generally made [4, 5]. A chevron osteotomy is well established by the AO foundation and has stood the test of time. Normally, a ’V’-shaped osteotomy is * Somasekhara Reddy Nallamilli [email protected] Rajyalakshmi N. Reddy [email protected] Mohan Krishna Althuri [email protected] 1
Apollo Hospital, #957, International pavilion, Jubilee Hills, Hyderabad 500033, Telangana, India
Apollo Hospital, Hyderabad, India
2
made with the apex distal and the chevron in a medio-lateral direction in the coronal plane (Fig. 1) [6]. This study aims to present a safe and easy technique of olecranon osteotomy, where the apex of the ‘V’ is still distal but the chevron is in an antero-posterior direction in the sagittal plane and is performed usi
Data Loading...
