Surgical management of the olecranon fractures with emphasis on merits and demerits of various surgical management techniques with the assessment of joint stability and motion: A clinical study

Abstract

Background: Surgical intervention has gained popularity and became a vital management strategy. The early active mobilization following surgery helps early restoration of the normal function. This active and early mobilization helps in early fracture union rapidly with the prevention of tissues from the fracture. Objectives: The present study was conducted to clinically evaluate the outcomes following the surgical treatment of the Olecranon fractures using plate fixation in comminuted fractures and using tension band wiring for simple transverse fracture. The study also evaluated the demerits and merits of the procedure with stability and elbow joint motion after surgical management of the olecranon fracture. Materials and Methods: In 23 subjects from both genders, comminuted fractures were treated with an olecranon hook plate and simple transverse fractures with tension band wiring with K-wire. The study results were assessed at 3 months postoperatively. At the recall visits, clinical examination was conducted for all the subjects for assessing muscle power related to the treated joint, cancellous screw head prominence, elbow joint movement, tenderness, and joint swelling. Joint movement and its restrictions, swelling, and pain were also assessed at recall visits. The collected data were subjected to evaluation and the results were formulated. Results: Based on Mayo Elbow Performance scores. It was seen that excellent results with scores of more than 90 were seen in 69.56% (n=16) of study subjects. The Good result was seen in 13.04% (n=3) study subjects. The results were fair in 17.39% (n=4) of study subjects. The poor results were not seen in any subject. No complications were seen in 73.91% (n=17) study subjects. Symptomatic metal prominence was seen in 13.04% (n=3) of study subjects. Superficial infection was seen in 8.69% (n=2) of study subjects. Implant loosening was the least common complication seen only in 4.34% (n=1) study subject. Conclusion: The present study concludes that managing the Olecranon fracture using comminuted fracture with Olecranon hook plate and tension band with K-wire for simple transverse fracture with open reduction and internal fixation are efficacious treatment modalities with very few demerits.