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Erschienen in:
09.07.2020 | Original Paper
Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications
Erschienen in: International Orthopaedics | Ausgabe 11/2020
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Purpose
To report radiologic, functional outcomes, and complications with a long-term follow-up in acute olecranon fractures treated with osteosynthesis and, secondly, to determine the predisposing factors to arthritis.
Methods
Forty-two patients treated with osteosynthesis for acute olecranon fractures were reviewed, with a minimum follow-up of 24 months. Radiological and clinical evaluations including DASH, MEPS, active range of motion, pain, arthritis, associated lesions, and complications were recorded. Arthritis was classified according to Broberg-Morrey scale. A logistic regression model was estimated to determine risk factors to develop ulnohumeral arthritis. The association between the types of fractures according to Mayo classification and MEPS, and the association between the type of fracture and the presence of pain were analyzed.
Results
The average follow-up was of 43.64 months. The flexion-extension average range was 135.6°, and the mean MEPS was 89.45; the DASH was 25.26. Eighteen cases (42.86%) were fixed with pre-contoured locking plates, 21 with tension band wiring (50%), and 3 with cannulated screws of 7 mm (7.14%). Six cases (14.29%) needed hardware removal. All fractures healed. Ulnohumeral osteoarthritis was observed in 14 cases (33.3%). We did not find a significant association among the MEPS, pain, and the fracture type, according to Mayo (p > 0.1 for both values). A significant association was found (p < 0.05) between fracture type and the osteoarthritis.
Conclusions
In olecranon fractures, good functional and radiological results with low complications are predictable. The osteoarthritis is possible in more complex fractures and with other associated fractures.