Treatment of olecranon fractures with 2.4- and 2.7-mm plating techniques.
OBJECTIVE
To evaluate the outcomes of olecranon fractures treated with 2.4- and 2.7-mm plate constructs.


METHODS
Retrospective Case Series.


METHODS
One-level 1 trauma center and 1 tertiary care hospital.


METHODS
Thirty-five consecutive patients meeting inclusion criteria.


METHODS
A 2.7- or 2.4-mm reconstruction plate was placed on the dorsal ulnar cortex and contoured to allow passage of either a 2.7- or 3.5-mm intramedullary screw. In 9 patients, additional plates were required to control comminution. Available computed tomographic (CT) scans were evaluated for the presence of comminution.


METHODS
Average Disabilities of the Arm, Shoulder, and Hand (DASH) and Mayo Elbow Performance Score (MEPS).


RESULTS
All fractures were united. Average extension deficit was 4.2 degrees, and average flexion angle was 137.4 degrees. Outcome scores were completed by 94% (33/35) of study patients. Average DASH score was 6.6, and average MEPS score was 94.5. Implants were removed in 18 patients. In the cohort of patients with CT scans, 6 of the 7 fractures thought to be simple on plain film analysis were found to have occult comminution on CT scan.


CONCLUSIONS
Comminution should be considered in all olecranon fractures, even when plain films display simple patterns; although this did not affect treatment in this series of plated patients, it may be important if selecting tension band wiring. Fixation with 2.4- and 2.7-mm plates addresses comminution in olecranon fractures, avoiding the pitfalls of tension band wiring. In patients with completed outcome scores, 97% (32/33) reported their outcomes as good or excellent according to the MEPS.


METHODS
Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
*Department of Orthopaedic Surgery, Hospital for Special Surgery, New York, NY; and †Department of Orthopaedic Surgery, New York Presbyterian Hospital, Weill Cornell Medical College, New York, NY.
David S
DS
Wellman
Lionel E
LE
Lazaro
Rachel M
RM
Cymerman
Thomas W
TW
Axelrad
David
D
Leu
David L
DL
Helfet
Dean G
DG
Lorich
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation*; D018460:Fractures, Comminuted / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D055815:Young Adult; D000092464:Elbow Injuries