[Treatment of traumatic lesions of the bursa olecrani and chronic bursitis olecrani].
OBJECTIVE
Complete olecranon bursectomy with debridement, protection of veins and nerves. Risk-adapted antibiotic therapy and early functional aftercare.


METHODS
Acute, traumatic laceration of the bursa olecrani, chronic therapy-resistant bursitis olecrani.


METHODS
For traumatic bursa injuries: general contraindications for anesthesia and surgery; chronic bursitis: initially not closable skin defect (plastic surgery required), hemodynamically instable patient (e.g. systemic inflammatory response syndrome [SIRS] or sepsis), pre-existing skin infection.


METHODS
Local anesthesia beyond the lesion, careful debridement, identification and removal of the entire bursa, excision of contaminated skin, lavage, drain insertion (Redon, Easy-flow, Penrose). Wound closure, elastic bandage, and splint.


METHODS
Elastic bandage for 2 days, followed by drain removal. Wound assessment, early functional aftercare without splint, antibiotic therapy in septic bursitis for 2 weeks, PRICE scheme. Removal of stitches after 10-12 days.


RESULTS
Over 5 years, 138 cases of traumatic bursa lesion or chronic bursitis olecrani were treated in our clinic, 82 patients underwent surgery. Ten patients were treated with vacuum-assisted closure therapy and consecutive wound healing; fistulae occurred in two patients and in another two dehiscence developed. All of the defects could be closed without flaps.
Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland. Dominik.Saul@med.uni-goettingen.de.
D
D
Saul
Klinik für Unfallchirurgie, Orthopädie und Plastische Chirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
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K
Dresing
D001458:Bandages; D002061:Bursa, Synovial / Q000601:surgery*; D002062:Bursitis / Q000601:surgery*; D003131:Combined Modality Therapy / Q000379:methods; D003646:Debridement / Q000379:methods*; D004551:Elbow Joint / Q000601:surgery; D019317:Evidence-Based Medicine; D056740:Olecranon Process / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D013524:Surgical Flaps / Q000637:transplantation; D014213:Tretoquinol; D058106:Wound Closure Techniques
D014213:Tretoquinol
Bursectomy; Bursitis; Elbow; Olecranon; Wound healing