scholarly journals Evaluation of the Results of Internal Fixation of Olecranon Fracture: Comparative Study between Olecranon Plate and Screws Versus Tension Band and K Wires

2021 ◽  
pp. 11-16
Author(s):  
Ahmed Mahmoud Mohammed ◽  
Osama Elgebaly ◽  
Ahmed Samy ◽  
Mamdouh Lashin
Keyword(s):  
Plate Fixation ◽  
Tension Band ◽  
Olecranon Fracture ◽  
Fixation Method ◽  
Dash Score ◽  
Locked Plate ◽  
Improvement Rate ◽  
Group I ◽  
Pin Fixation ◽  
K Wires

Background: Olecranon fractures constitute a large proportion of injuries about the elbow. Several fracture patterns are recognized, with each pattern lending itself to a different treatment modality ranging from conservative treatment to fixation by different methods like tension band wiring, olecranon plate, intramedullary screw with or without tension band, and single Rush pin fixation. This study aimed to evaluate and compare the result of fixation of olecranon fracture tension band with K-wire and posterior olecranon special non locked plate fixation. Materials and Methods: This study included 30 patients, prospectively of simple olecranon fracture. Patients were randomly classified into two equal groups; group I was managed by tension band and K wires, while group I was managed by special non locked olecranon plate and screws. Results: No significant differences were found between both groups in DASH score, range of motion, improvement rate, radiological outcomes and return to previous activities. Conclusion: There were no significant differences between the two-fixation method regarding to DASH, ROM, radiological outcomes, and return to previous activity but rate of hardware removal was higher in tension band and K wires than posterior olecranon special non locked plate fixation.

scholarly journals Midterm Results of Four-Corner Fusion Using Dorsal Circular Plate Fixation

2017 ◽  
Vol 07 (03) ◽  
pp. 262-266 ◽  
Author(s):  
Claus Deglmann ◽  
Vanja Celigoj ◽  
Bernhard Lukas ◽  
Ahmed Elgammal
Keyword(s):  
Circular Plate ◽  
Plate Fixation ◽  
Fixation Method ◽  
Dash Score ◽  
Level Of Evidence ◽  
Plate Removal ◽  
Level Ii ◽  
The Mean ◽  
K Wires

Purpose The purpose of this prospective study was to evaluate the results of four-corner fusion using dorsal circular plate. Methods We operated on 20 patients between 2009 and 2011. Results At a mean follow-up period of 30 months (range: 14–62, SD: 16), the mean VAS improved from 8 (range: 4–10, SD: 2) preoperatively to 4 (range: 0–8, SD: 2). Function measured with the DASH score improved from 37 (range: 10–75, SD: 18) to 26 (range: 2.5–64, SD: 19). Eighteen patients in our series showed full consolidation and two patients showed persistent nonunion. Three cases required plate removal due to dorsal impingement. Conclusion  Four-corner fusion using dorsal circular plate showed satisfactory results in this study, but it did not show superior results compared with simpler fixation methods mentioned in the literature, such as K-wires or screw fixation. Currently, we are principally using K-wires as a fixation method of choice in our four-corner fusion procedures. Level of Evidence  Level II.

scholarly journals Best technique for fixation of displaced transverse olecranon fractures: tension band wiring or plate fixation?

2020 ◽  
Vol 6 (5) ◽  
pp. 1012
Author(s):  
Lokesh Kumar Yogi ◽  
Gagandeep Mahi ◽  
C. R. Thorat ◽  
Moti Janardhan Naik
Keyword(s):  
Functional Outcome ◽  
Large Scale ◽  
Plate Fixation ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Clinical Event ◽  
Dash Score ◽  
Group A ◽  
Group B ◽  
Olecranon Fractures

<p><strong>Background:</strong> Fractures of olecranon are common fractures in upper limb. Tension band wiring (TBW) and plate fixation (PF) are mostly used techniques but choice is based on type of fracture and surgeon’s preference.</p><p><strong>Methods:</strong>  A study assessed functional results in 28 patients that were enrolled after the clinical event of trauma has occurred. Patients were divided into two groups- Group (A) for TBW and Group (B) for PF; here gender, age and side of fracture were ignored. Post-operative functional outcome were evaluated by using the Mayo Elbow Performance (MEP) and the Disabilities of the Arm, Shoulder and Hand (DASH) score parameters.</p><p><strong>Results:<em> </em></strong>Mean (SD) union time as determined by postoperative radiographs was 8.5 (1.48) weeks for group (A) and 9 (2.08) weeks for group (B). Mean (SD) MEP score at 9 months in group (A) 84.28 (7.28) and 80.71 (10.92) in group (B). Mean (SD) DASH at 9 months in group (A) 12.2 (8.8) and 11.7 (10.4) in group (B). Complications were reported in group (A) 6 patient (42.85%) out of 14 patients and in group (B) 1 patient (7.14%) out of 14 patients.</p><p><strong>Conclusions:<em> </em></strong>The current study shows that there are no significant differences in functional outcome between both the study groups. Due to lesser complications, we recommend the plate fixation approach as the better choice for transverse displaced olecranon fractures. More large scale studies are required to further confirm our results.</p>

scholarly journals Intramedullary screw fixation for simple displaced olecranon fractures

2019 ◽  
Vol 46 (1) ◽  
pp. 83-89 ◽  
Author(s):  
Willem-Maarten P. F. Bosman ◽  
Benjamin L. Emmink ◽  
Abhiram R. Bhashyam ◽  
R. Marijn Houwert ◽  
Jort Keizer
Keyword(s):  
Soft Tissue ◽  
Plate Fixation ◽  
Cannulated Screw ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Hardware Removal ◽  
Dash Score ◽  
Intramedullary Screw ◽  
Olecranon Fractures

Abstract Purpose Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. Methods We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). Results By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. Conclusions Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.

Complications of lateral plate fixation compared with tension band wiring and pin or lag screw fixation for calcaneoquartal arthrodesis

2013 ◽  
Vol 26 (06) ◽  
pp. 445-452 ◽  
Author(s):  
C. S. Knudsen ◽  
M. Gosling ◽  
M. McKee ◽  
R. G. Whitelock ◽  
G. I. Arthurs ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Screw Fixation ◽  
Plate Fixation ◽  
Tension Band ◽  
Complication Rates ◽  
Lateral Plate ◽  
Lag Screw ◽  
Tension Band Wire ◽  
Plate Group ◽  
Pin Fixation

SummaryObjective: To compare complication rates and the outcomes of these complications after lateral plate fixation with figure-ofeight tension-band-wire and pin or lag screw fixation for arthrodesis of the calcaneoquartal joint, following non-traumatic disruption of the plantar tarsal ligament in dogs.Methods: Data were collected retrospectively from five UK referral centres. Diplomate specialists and their residents performed all procedures. Referring veterinarians were contacted for long-term follow-up.Results: Seventy-four procedures were undertaken in 61 dogs. There were 58 arthrodeses in the lateral plate group (Plate), nine in the pin and tension-band-wire group (Pin), and seven in the lag screw and tension-band wire-group (Screw). Compared to Plate (17%), further surgical intervention was required more frequently following Pin (56%, OR = 3.2) or Screw (43%, OR = 2.5) fixation. Clinical failure of arthrodesis occurred less frequently with Plate (5%) compared with Screw (43%, OR = 8.6) and Pin fixation (22%, OR = 4.4). Cases managed with external coaptation postoperatively were more likely to suffer from postoperative complications (OR = 2.2).Clinical significance: Lateral plating was associated with fewer postoperative complications than pin and tension-band-wire fixation for arthrodesis of the calcaneoquartal joint in dogs with non-traumatic disruption of the plantar tarsal ligament.

scholarly journals Comparative study of tension band wiring and pre contoured locking compression plate fixation in olecranon fractures in adults

2021 ◽  
Author(s):  
Mohit Mahoviya ◽  
Pradeep Choudhari ◽  
Divyanshu Patel ◽  
Arpit Choyal
Keyword(s):  
Comparative Study ◽  
Internal Fixation ◽  
Plate Fixation ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Improvement Rate ◽  
Articular Fractures ◽  
Group A ◽  
Group B ◽  
Olecranon Fractures

<p class="abstract"><strong>Background:</strong> Olecranon fractures are about 10% of all proximal forearm fractures.Mostly intra articular fractures, require anatomical reduction and internal fixation for satisfactory clinical outcomes. The most commonly used techniques are still tension band wiring (TBW) and plate fixation (PF). The aim of the current study is to discuss whether TBW or PF technique of internal fixation is better in the treatment of olecranon fractures.</p><p class="abstract"><strong>Methods:</strong> This is a comparative study including 30 adult patients of olecranon fracture classified by Mayo classification and operated upon by tension band plating (group A) and tension band wiring (group B) at Department of Orthopaedics, Sri Aurobindo Medical College and PG Institute, Indore. All operated cases between the period of January 2018 to August 2019 with follow up of 1 year were assessed on the basis of functional outcome using Mayo elbow performance score<strong> </strong>(MEPS).<strong></strong></p><p class="abstract"><strong>Results:</strong> The MEPS, 73% of the patients in group A achieved a good to excellent results in comparison to 60% in group B. no significant differences between the two groups could be detected regarding the clinical and radiographic outcome.</p><p class="abstract"><strong>Conclusions:</strong> Both TBW and PF interventions had treatment benefit in OFs. The current study reveals that there are no significant differences in MEPS, improvement rate and ROM between TBW and PF for OFs. More high-quality studies are required to further confirm our results as most of the cases included in study belonged to Mayo type IIA category.</p>

scholarly journals More metalwork removals in patients with olecranon fracture treated by tension band wiring than plate fixation-a propensity score matching analysis

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Longhai Qiu ◽  
Yi Li ◽  
Hongbo Wu ◽  
Ruixiong Chen ◽  
Zhiwen Zhang ◽  
...  
Keyword(s):  
Logistic Regression ◽  
Propensity Score ◽  
Propensity Score Matching ◽  
Plate Fixation ◽  
Treatment Method ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Olecranon Fracture ◽  
Propensity Score Matching Analysis ◽  
Olecranon Fractures

Abstract Background Traditional tension band wiring and plate fixation represent the commonest methods for treating olecranon fractures. However, there is no agreement on which method provides the best outcome. The aim of this retrospective study is to compare the outcomes of tension band wiring (TBW) and plate fixation (PF) for treating displaced olecranon fractures. This is the first study to use propensity score matching analysis to compare treatment methods for olecranon fracture. Method A total of 107 patients aged between 18 and 85 had acute isolated and displaced olecranon fractures. The patients were divided into either TBW (n = 49) or PF (n = 58) groups. To conduct propensity score matching for the treatment method (TBW versus PF), 58 patients were analyzed by logistic regression (29 patients in each group). Various demographic and treatment-related variables were examined and analyzed to determine their correlation. Results Functional effects between two groups are similar (in terms of Mayo Elbow Performance Score (MEPS), the patients’ range of elbow motion (ROM) and forearm rotation (RFR), the time return to work (RTW)). The total adverse events rate and metalwork removal events rate are higher in TBW than that in PF. After propensity score matching analysis, similar primary treatment efficacy (indicated by MEPS> 90) in 2 groups and more primary adverse events (indicated by metalwork removal) were perceived in TBW than that in PF. Logistic regression analysis revealed that fracture type was an independent factor that affected the efficacy of a treatment (regression coefficient = − 1.24 < 0, P = 0.03), indicating that fracture severity was inversely proportional to the efficacy of a treatment for olecranon fracture. Furthermore, logistic regression analysis demonstrated that the treatment method was an independent factor that affected metalwork removal of olecranon fracture (regression coefficient 2.38 > 0, OR = 10.77, P < 0.01), indicating that the risk of metalwork removal in the TBW Group was 10.77 times that in the PF Group. Conclusion When initially discussing the surgical approach with patients, physicians should fully weigh the possibility that TBW may lead to a second surgery due to the higher risk of internal fixation removal and that TBW won’t yield better functional outcomes than PF .

scholarly journals Randomized Prospective Study of Olecranon Fracture Fixation: Cable Pin System versus Tension Band Wiring

2012 ◽  
Vol 40 (3) ◽  
pp. 1055-1066 ◽  
Author(s):  
Q-H Liu ◽  
Z-G Fu ◽  
J-L Zhou ◽  
T Lu ◽  
T Liu ◽  
...  
Keyword(s):  
Fracture Healing ◽  
Fracture Fixation ◽  
Randomized Study ◽  
Healing Time ◽  
Outcome Data ◽  
Tension Band ◽  
Tension Band Wiring ◽  
Olecranon Fracture ◽  
Fixation Method ◽  
The Mean

OBJECTIVE: This prospective, randomized study compared the effectiveness of the cable pin system (CPS) versus tension band wiring (TBW) for olecranon fracture fixation. METHODS: Patients with acute transverse or slight oblique olecranon fractures were randomly divided into two groups: one fixed by CPS and the other by TBW. Clinical outcome data were collected and analysed following a mean duration of 21 months. RESULTS: The mean ± SD fracture healing time was significantly shorter in the CPS group ( n = 30; 9.73 ± 2.02 weeks) compared with the TBW group ( n = 32; 11.13 ± 2.21 weeks). One patient in the CPS group and seven patients in the TBW group experienced postoperative complications; this difference was statistically significant. The mean ± SD Mayo Elbow Performance Score in the CPS group was significantly higher (88.67 ± 6.42) than that in the TBW group (80.78 ± 11.99). Logistic regression analysis showed an association between fixation method and fracture healing time, complications and elbow function. CONCLUSIONS: Internal fixation by CPS is an effective method for olecranon fracture and is associated with a shorter healing time, fewer complications and better function than TBW.

Percutaneous K-wires vs palmar locking plate fixation for different types of distal radial fractures: a comparison of the outcomes of two methods to controll our guidelines

2018 ◽  
Vol 50 (05) ◽  
pp. 319-325
Author(s):  
Andrzej Zyluk ◽  
Piotr Janowski ◽  
Zbigniew Szlosser ◽  
Piotr Puchalski
Keyword(s):  
Locking Plate ◽  
Plate Fixation ◽  
Fixation Method ◽  
Locking Plate Fixation ◽  
Distal Radial Fractures ◽  
Fixation Group ◽  
Palmar Plate ◽  
Wire Fixation ◽  
K Wires ◽  
Dorsal Flexion

AbstractThe objective of the study was a comparison of the outcomes of K-wire vs plate fixation for distal radial fractures used according to the proposed institutional algorithm. Fracture configurations A2, A3, B1, B2, C1 and some C2 were operated on with K-wire pinning, whereas B3 and some B2, C3 and some C2 were with locking palmar-plate fixation. Patients and Methods: Four hundred and sixty-seven patients were non-randomly allocated for either K-wire (n = 363) or palmarplate (n = 104) fixation. The results were assessed at 3 and 12 months by the same outcome measures. Results: At the 3-month assessment, statistically significant differences in grip strength and the DASH scores were noted in favour of the plate-fixation group. At the 12-month assessment, statistically significant differences were observed in the wrist palmar and dorsal flexion, favouring the plate-fixation group. Statistically significant differences were noted in radiological measures of the palmar tilt and the ulnar variance, both favouring the plate-fixation method. Meaningful secondary dislocations were noted in ten patients, all in the K-wire-fixation group. Conclusion: We conclude that palmar locking plate fixation in even more severe fractures leads to better radiological and clinical outcomes than K-wire fixation in less severe fractures.

scholarly journals 653 DRAFFT Dodging? Fixation Methods for Distal Radial Fractures Since 2014 In A UK Trauma Unit

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
J Gilbert ◽  
H Akehurst ◽  
J Mutimer
Keyword(s):  
Internal Fixation ◽  
Distal Radius ◽  
Locking Plate ◽  
Plate Fixation ◽  
Distal Radius Fractures ◽  
Fixation Method ◽  
Radius Fractures ◽  
Locking Plate Fixation ◽  
Fixation Methods ◽  
K Wires

Abstract Introduction The 2014 randomised, controlled Distal Radius Acute Fracture Fixation Trial (DRAFFT) compared K-wires to internal fixation for management of dorsally displaced distal radius fractures. The authors found no clinical difference between the two fixation methods, concluding ‘The results of this trial will reverse the trend towards locking-plate fixation for this injury’. Our study aimed to measure local change in practice since 2014. Method From the DRAFFT CONSORT diagram, we calculated just 10.7% of eligible cases required locking plate fixation. 300 patients, 50 per year from 2014-19 meeting DRAFFT eligibility criteria undergoing fixation, were randomly selected from an electronic trauma database. Radiographs were reviewed to see whether patients received internal fixation or K-wires. Results Age and sex distributions of the study sample were not significantly different to the DRAFFT population (p &lt; 0.05). Over 60% of recruited patients received internal fixation each year. No increasing trend in use of K-wires was detected (p = 0.27). No trend was observed in either fixation method adjusting for intra versus extra-articular fractures (p = 0.36). Conclusions Local practice remains unchanged in fixation of dorsally displaced distal radius fractures since 2014. Internal fixation remains the most prevalent surgery, and there has been no detectable increase in use of K-wires.

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