A CLINICAL STUDY OF SURGICAL MANAGEMENT OF OLECRANON FRACTURES

Main Article Content

Dr. Nitin Jeenjwadia
Dr. Raghvendra Choubisa
Dr. Dinesh Kumar Meena
Dr. A.K. Mehra

Keywords

Olecranon fractures, Tension band wiring, Olecranon plate.

Abstract

Background and Objective: Olecranon fractures are one of the most commonly seen orthopaedic injuries in emergency room. Fractures of the Olecranon typically occurs as a result of RTA, a fall or assault. The accepted management for Olecranon fractures is for non displaced fractures short immobilization followed by gradually increasing range of motion. When displaced, open reduction and internal fixation with k-wire and figure of eight tension band wiring for simple transverse fractures and Olecranon plate for comminuted fractures. The present study is undertaken to evaluate the result of surgical management, the merit and demerits and to asses elbow joint motion and stability after the procedure.


Material and Methods: It is a prospective study which was carried out from August 2019 to November 2020 in Maharana Bhupal General Hospital attached to RNT Medical College, Udaipur. In this study period 25 case of fracture Olecranon treated by Tension band wiring with K-wire for simple transverse fracture and Olecranon plate for communited fractures.


Results: In our series, majority of patients were males, middle age with RTA being the commonest mode of injury. Most of the cases were Type || B fractures I.e., oblique and transverse fractures according to Colton‟s classification. Surgery was performed with in 4.76 average days. Union was noted clinically, radiologically and functional evaluation was done by Mayo elbow performance score. Excellent results was present in 19(76%) patients, 4(16%) good and 2(8%) fair with no poor result.


Conclusion: From the present study it is concluded that the technique of open reduction and internal fixation with K-wire and tension band wiring for simple transverse and oblique fractures and Olecranon plate for comminuted fractures are effective means and gold standard technique of treating fracture of Olecranon and is based on sound biomechnical principal.

Abstract 71 | PDF Downloads 34

References

1. David Ring “ Elbow fractures and dislocations in „Rockwood and Green Fractures in Adults‟ Chapter 32 Vol I 7th, Bucholz RW, Heckman JD,, Lippincott Williams& Wilkins.2010, 936-942.
2. Williams Peter L. and Roger Werrwick, 'Joints of the upper limb". Chapter-4, in Arthrology, Gray's Anatomy, 36th Edn., London, Churchill Livingstone, 1980: 460-464pp.
3. Regan WD, Morrey BF. The physical examination of the elbow. In Morrey BF, editor: The elbow and its disorders, ed 2, Philadelphia, 1993, 81.
4. Colton CL, : “Fractures of the olecranon in adults : Classification and management”. Injury, 1973,5: 121-129.
5. Daland EM,: “Fractures of the olecranon”. J Bone Joint Surg,1933 15: 601- 607.
6. Jiang Xieyuan et al. “Operative treatment of olecranon fracture associated with anterior dislocation of the elbow”. Chinese J of Orthop, 2000;20(3): 154- 156.
7. Wolfgang G., et al : “Surgical treatment of displaced olecranon fractures by tension band wiring technique”. Clin Orthop,1987, 224: 192-204.
8. Murphy D.F., et al : “Displaced olecranon fractures in adults. Biomechanical analysis of fixation methods”. Clin Orthop,1987, 224: 210-4.
9. Murphy D.F., Greene W.B. and Damerson T.B., : “Displaced olecranon fractures in adults. Clinical evaluation”. Clin Orthop,1987, 224: 215-23.
10. Hume, Mary C, and Wiss, Donald A,: “Olecranon fractures”. 1992, Clin Orthop, 285: 229-235.