Abstract
Introduction
The purpose of this investigation was to review the preliminary results and patients
outcome following treatment with an anatomically preshaped LCP in patients with comminuted
fractures of the proximal ulna. We hypothesized that this fixation system provides
equal or superior results in fracture care when compared with other available plating
devices, but results in better patient's comfort due to its low-profile design.
Patients and methods
Between 2007 and 2009, 15 patients with comminuted fractures of the proximal ulna
including three posterior Monteggia fractures were managed with the preshaped LCP
olecranon plate. The patients were invited for clinical examination at a mean duration
of 16 months, retrospectively. Validated patient-oriented assessment scores involving
the Mayo Elbow Performance Index (MEPI) and the shortened Disability of the Arm, Shoulder
and Hand (Quick-DASH) score, postoperative range of motion, objective muscle-strengths testing and
patient's satisfaction were evaluated. All patients had follow-up radiographs.
Results
Fourteen patients were available for evaluation. The mean arc of elbow motion was
129°. The mean MEPI was 97 with good results in two patients and excellent results
in 12 patients. The mean Quick-DASH was 13. Thirteen of fourteen patients documented satisfaction with their elbow
outcome. There was one patient with symptomatic hardware and one patient complained
about deficit of motion. In four patients the hardware was removed including two patients
with elective removal. Fourteen fractures healed with ulnohumeral congruity after
a mean time to union of 11 weeks. One fracture non-union occurred without mechanical
failure or loss of reduction.
Conclusion
Anatomically preshaped LCP olecranon plating is an effective fixation method for comminuted
fractures of the proximal ulna allowing reliable stability for early elbow motion.
The functional results are comparable with formerly described plating systems. A low
rate of symptomatic hardware removal suggests better patient's compatibility.
Keywords
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References
- Congruent elbow plate fixation of olecranon fractures.J Orthop Trauma. 2007; 21: 386-393
- Precontoured parallel plate fixation of AO/OTA type C distal humerus fractures.J Orthop Trauma. 2009; 23: 575-580
- The Monteggia lesion.Clin Orthop. 1967; 50: 71-76
- Outcome of plate fixation of olecranon fractures.J Orthop Trauma. 2001; 15: 542-548
- Surgical exposure of the ulna and proximal third of the radius through one incision.Surg Gynecol Obstet. 1940; 71: 87-88
- Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating.Arch Orthop Trauma Surg. 2010; 130: 459-464
- Clinical evaluation of locking compression plate fixation for comminuted fractures.J Bone Joint Surg. 2009; 91: 2416-2420
- Fractures of the proximal ulna and olecranon.in: Morrey B.F. The elbow and its disorders. WB Saunders, Philadelphia1993: 407-408
- Biomechanics of locked plates and screws.J Orthop Trauma. 2004; 18: 488-493
- Methods of fixation of olecranon fractures. An experimental mechanical study.J Bone Joint Surg Br. 1985; 67: 367-372
- Standardisation and validation of the German version 2.0 of the Disability of Arm, Shoulder, Hand (DASH) questionnaire.Unfallchirurg. 2003; 106: 13-19
- The Coonrad–Morrey total elbow arthroplasty in patients who have rheumatoid arthritis. A ten to fifteen-year follow-up study.J Bone Joint Surg Am. 1998; 80: 1327-1335
- Comminuted olecranon fractures: a comparison of plating methods.J Shoulder Elbow Surg. 2006; 21: 386-393
- Prevention of infection in the treatment of one thousand and twenty-five open fractures of long bones: retrospective and prospective analyses.J Bone Joint Surg Am. 1976; 58: 435-438
- Olecranon fractures: treatment options.J Am Acad Orthop Surg. 2000; 8: 266-275
- The complications of surgical treatment of displaced fractures of the olecranon.Injury. 1987; 18: 48-50
- A clinical and radiographic comparison of tension band wiring and plate fixation.Clin Orthop. 1992; 12: 1469-1472
- The posterior Monteggia lesion.J Orthop Trauma. 1991; 5: 395-402
- Treatment of proximal ulna and olecranon fractures by dorsal plating.Oper Orthop Traumatol. 2009; 21: 571-585
- Olecranonfrakturen.in: Stöckle U. Ellenbogenchirurgie. Elsevier, München2009: 94-103
- Some observations on fracture of the head of radius with a review of one hundred cases.Br J Surg. 1954; 42: 123-132
- Functional outcome following treatment of transolecranon fracture-dislocation of the elbow.Injury. 2006; 37: 284-288
Müller ME, Allgöwer M, Schneider R, Willenger H. Manual of internal fixation. Schatzker J. (translator), Techniques recommended by the AO-group. 2nd ed. New York: Springer; 1979.
- Olecranon fractures.Injury. 2009; 40: 575-581
- Surgical treatment of olecranon fractures.Am J Orthop. 2001; 30: 577-586
- Open proximal ulnar fracture 21-B1; simple ulnar shaft fracture 22-A1; anterior dislocation of the radial head.in: Wagner M. Frigg R. AO manual of fracture management: internal fixators: concepts and cases using LCP and LISS. Thieme, Stuttgart2006: 371-380
- Fractures of the coronoid process of the ulna.J Bone Joint Surg Am. 1989; 71: 1348-1354
- Stabilisation of articular fractures of the distal humerus: early experience with a novel perpendicular plate system.Injury. 2009; 40: 611-617
- Transolecranon fracture-dislocations of the elbow.J Orthop Trauma. 1997; 11: 545-550
- Loss of alignment after surgical treatment of posterior Monteggia fractures: salvage with dorsal contoured plating.J Hand Surg Am. 2004; 29: 694-702
- Olecranon fractures in adults: factors influencing outcome.Injury. 2004; 35: 1149-1157
- Preformed plate-fixation system for type AO-13C3 distal humerus fractures: clinical experiences and treatment results taking access into account.Unfallchirurg. 2008; 111: 308-322
- Proximal ulna fractures.J Hand Surg Am. 2009; 34: 357-362
- Articular olecranon fracture 21-B1.in: Wagner M. Frigg R. AO manual of fracture management: internal fixators: concepts and cases using LCP and LISS. Thieme, Stuttgart2006: 371-380
- Contoured LCDC plating of the proximal ulna.Injury. 1996; 27: 411-417
- Inidications and limitations of locked plating.Injury. 2009; 40: 683-691
- Posterior olecranon plating: biomechanical and clinical evaluation of a new technique.Bull Hosp Jt Dis. 2002–2003; 61: 27-31
- A technique of plating severe olecranon fractures.Injury. 1973; 5: 135-140
Article info
Publication history
Accepted:
August 4,
2010
Identification
Copyright
© 2010 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.