![]() She underwent hardware removal without further fixation X-rays confirmed loss of fixation due to infection. On postoperative week 4, she had increased pain and redness at her elbow. She sustained a 21–B1 closed olecranon fracture, which was treated with TB. The single prominent pin was removed, and she went on to union. Hardware removal was delayed until postoperative week 8 to allow for union. She complained of hardware prominence at her first clinic visit. a A 77-year-old woman had a ground-level fall. P values for all analyses were considered to significantly depart from chance at a p < 0.05.Ĭomplications with tension band (TB). After analysis, we reported adjusted odds ratios (OR) and their corresponding 95 % confidence intervals (CI) along with p values. In analysing re-operation rates within the study, we controlled for treatment type, age, ASA score, gender and open fractures. To determine differences in outcomes between treatment groups, multivariate logistic regression was used. All differences in proportions were tested with Pearson’s chi-squared test, except in cases with fewer than ten variables, in which case Fisher’s exact test was used. To test for differences in average age of treatment and hardware removal groups, Student’s t test for independent samples was used. To confirm and validate interobserver reliability in our review, two authors performed the chart analysis of all notes and reports. Information regarding postoperative course was obtained from follow-up clinic notes, emergency department notes and subsequent operative reports. These included nonunion, malunion, postoperative infection, loss of function, fixation failure, elective implant removal and other complications requiring an unplanned surgical intervention. Individual charts were reviewed for complications following operative management. Operative reports and electronic radiographs were reviewed to identify patients who underwent TB or ORIF. Each patient chart was examined to obtain demographic information, including age, sex, body mass index (BMI) and American Society of Anesthesiologists (ASA) classification. Open fractures were identified on the basis of resident and attending physician documentation. The fracture pattern was determined from analysis of preoperative images and classified using the Orthopaedic Trauma Association (OTA) system. We excluded patients with other injuries to the ipsilateral extremity and skeletally immature patients. All patients who underwent operative treatment from August 2003 to July 2013 were included in the study. An additional aim of the study was to compare the two types of fixation techniques in terms of rates of re-operation requiring hardware removal.Īfter receiving approval from the Vanderbilt Institutional Review Board, we performed a retrospective study of patients who underwent fixation of an olecranon fracture (CPT code 24685) at our level 1 trauma centre. The primary goal of this study was to compare factors influencing complication rates for both TB and ORIF of isolated olecranon fractures over the course of ten years at a single level 1 trauma centre. Whereas the overall incidence of complications for both TB and ORIF of olecranon fractures is relatively low, it would be advantageous for surgeons to possess additional outcome data for both techniques in order to guide their surgical decisions and reduce re-operation rates. For both types of fixation, the most common postoperative complications leading to re-operation include arthrosis, infection, ulnar neuritis and symptomatic hardware issues requiring removal. Previous studies comparing rates of re-operation following TB and ORIF of olecranon fractures have yielded equivocal results. Whereas open reduction internal fixation (ORIF) is considered the most effective treatment for comminuted olecranon fractures, there is debate about whether TB or ORIF is more effective for treating simple fracture patterns. c Screw fixationĬommonly used treatment methods for internal fixation of olecranon fractures include plate fixation, tension-band (TB) wiring and intramedullary screw fixation. b Open reduction internal fixation (ORIF). Olecranon fracture after operative fixation. ![]()
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