Outcome of isolated olecranon fractures in skeletally immature patients: comparison of open reduction and tension band wiring fixation versus closed reduction and percutaneous screw fixation

Eur J Orthop Surg Traumatol. 2016 Jul;26(5):469-76. doi: 10.1007/s00590-016-1774-y. Epub 2016 Apr 30.

Abstract

Purpose: The olecranon fracture is an uncommon injury reported to incur many possible complications in children. The aim of this study was to compare the outcome of two different surgical techniques in isolated olecranon fracture.

Methods: We retrospectively evaluated 22 children with isolated olecranon fracture treated by open reduction and tension band wiring fixation versus closed reduction and percutaneous screw fixation. We compared the dislocation before and after surgery by radiography. The patients were evaluated clinically with Quick DASH(®).

Results: Both techniques showed good radiological and clinical outcome (Quick DASH(®) 1.82 vs. 3.42) with no statistically significance difference (p > 0.05). In two cases (16.6 %) of the group treated with cannulated screw, it was necessary to convert into open reduction to obtain optimal reduction of the fracture. All the children returned to previous activity. In four cases, the extension of the elbow was slightly reduced (15°-20°), with no statistically significant difference in the two groups.

Conclusion: It is not contraindicated to operate skeletally immature patients with displaced olecranon fracture. However, results were essentially the same, and so either method is a satisfactory choice for pediatric displaced olecranon fractures, with equally acceptable radiological results and similar rate of complications and clinical outcome at final follow-up.

Level of evidence: III.

Keywords: Children; Displaced; Elbow; Olecranon fracture; Outcome; Surgery.

MeSH terms

  • Child
  • Elbow Joint / physiopathology
  • Female
  • Fracture Fixation, Internal* / adverse effects
  • Fracture Fixation, Internal* / instrumentation
  • Fracture Fixation, Internal* / methods
  • France
  • Humans
  • Joint Dislocations / etiology
  • Joint Dislocations / surgery
  • Male
  • Olecranon Process* / diagnostic imaging
  • Olecranon Process* / injuries
  • Open Fracture Reduction* / adverse effects
  • Open Fracture Reduction* / instrumentation
  • Open Fracture Reduction* / methods
  • Postoperative Complications* / diagnosis
  • Postoperative Complications* / etiology
  • Range of Motion, Articular
  • Recovery of Function
  • Retrospective Studies
  • Treatment Outcome
  • Ulna Fractures* / diagnosis
  • Ulna Fractures* / surgery