Olecranon sled fixation versus tension band wiring fixation in treatment of Mayo ⅡA olecranon fractures / 中华创伤骨科杂志

Objective:To compare the efficacy between olecranon sled fixation and tension band wiring fixation in the treatment of Mayo ⅡA olecranon fractures.Methods:A retrospective study was conducted to analyze the data of 54 patients with Mayo ⅡA olecranon fracture who had been admitted to Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital from October 2018 to February 2021. There were 20 males and 34 females with an age of (45.5±17.7 years), and 36 left and 18 right sides. They were divided into 2 groups according to different methods of internal fixation. Group A (25 cases) was subjected to olecranon sled fixation and group B (29 cases) to tension band wiring fixation. Preoperative data, operation time, reoperations and complications during follow-up were recorded and compared between the 2 groups. In both groups at the last follow-up, the range of the elbow motion, the Mayo elbow performance score (MEPS) and the Disabilities of the Arm, Shoulder and Hand (DASH) score were recorded to evaluate the elbow function.Results:The 2 groups were comparable because there were no significant differences in all their preoperative demographic data ( P>0.05). There were no significant differences between the 2 groups either in follow-up time [(32.8±8.9) months for group A and (35.8±9.0) months for group B] or in operation time [60.0 (60.0, 82.5) min for group A and 60.0 (60.0, 67.5) min for group B] ( P>0.05). At the last follow-up in group A and group B, respectively, the flexion and extension of the elbow was 141.0°±8.4° and 140.0 (140.0, 150.0)°, the pronation-supination 180.0 (175.0, 180.0)° and 180.0 (175.0, 180.0)°, the MEPS score 100.0 (85.0, 100.0) and 100.0 (92.5, 100.0), and the DASH score 4.2 (1.7, 6.3) and 5.8 (1.3, 8.3), all showing no statistically significant differences between the 2 groups ( P>0.05). Olecranon skin irritation occurred in 5 patients (20.0%,5/25) in group A and in 15 patients (51.7%,15/29) in group B, and 7 patients (28.0%,7/25) in group A and 21 patients (72.4%,21/29) in group B underwent removal of internal fixation, both showing statistically significant differences between the 2 groups ( P<0.05). Conclusion:In the treatment of Mayo ⅡA olecranon fractures, compared with tension band wiring fixation, olecranon sled fixation may lead to comparable efficacy in fixation and functional recovery, but significantly reduced rates of complications and internal fixation removal.

An Assessment of 3.5mm Reconstruction Plate Fixation in Olecranon Fractures

Background: Olecranon process is a large, curved eminence comprising of the proximal and posterior part of the ulna. It lies subcutaneously which makes it more vulnerable to injury. Due to intra-articular extension of fractures, anatomical reduction and early mobilization should be achieved in every case and usually managed surgically. Aims and Objectives: To access the results of reconstruction plate in fracture olecranon.Materials &Methods: This was a prospective study consisted of 25 cases of olecranon fractures which were managed by open reduction and internal fixation using 3.5mm reconstruction plate. Patients were followed up every month till 6 months. At each follow up visit clinical and radiological parameters were assessed: Final assessment was done at 6 months using the Mayo Elbow Performance Score.Result: According to the AO classification, Type A-1 � 7 cases, A-3 � 1case, B-1 � 13 cases, B-3 � 1 case, C-1 � 1 case, C-2 � 1 case, C-3 � 1 case. An adequate reduction was maintained in all fractured olecranon until union. Average radiological union time was 12 weeks in 72% cases, 15 weeks in 16% cases, 18 weeks in 8% cases and > 18 weeks in 4% cases. The results were graded as per the criteria laid by Rogers et al as excellent in 84% cases, good in 12% and unsatisfactory in 4% cases. 2 cases developed superficial infection and 1 deep infection and 1 delayed union.Conclusion: Open reduction and internal fixation of fracture of olecranon with 3.5mm reconstruction plate is based on sound biomechanical principle with a good functional outcome and a low incidence of complications

Wide-Awake Olecranon Tension Band Wiring with Ipsilateral Zone 6 Extensor Tendon Repair: A Case Report

@#Wide-awake local anaesthesia, no tourniquet (WALANT) continues to gain popularity and has been adapted for various fracture fixations proximal to the hand. A case of olecranon tension band wiring with concomitant extensor tendon repair is presented. The procedure was done with the patient awake in a lateral decubitus position 30min after the injection of WALANT solution at the intended surgical sites. Pain and discomfort were felt by the patient towards the end of the procedure mainly on his volar forearm where the bolster was placed. Olecranon fixation under WALANT is a viable alternative for patients who prefer to be awake or those with contraindications to general or regional anaesthesia. Alternative patient positioning may be considered, and perioperative pain control should not be overlooked.

Sled board internal fixation for olecranon fractures / 中华创伤骨科杂志

Objective:To investigate the therapeutic effects of sled board internal fixation on the treatment of olecranon fractures.Methods:The clinical data were retrospectively analyzed of the 21 patients with olecranon fracture who had been treated with sled board internal fixation at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital from May 2019 to January 2021. They were 11 males and 10 females with 14 left and 7 right sides affected, aged from 18 to 68 years (mean, 42.0 years). By the preoperative Mayo classification for olecranon fractures, one case was type ⅠA, 11 cases were type ⅡA and 9 cases type ⅡB; by the Schatzker classification, one case was type A, 4 cases were type B and 16 cases type C. The operation time and the complications were recorded; at the last follow-up, the range of motion of the elbow joint was recorded and the elbow function and pain were evaluated by the Mayo elbow performance score (MEPS) and visual analogue scale (VAS).Results:The 21 patients were followed up for 13 to 34 months (mean, 19.6 months) after operation. At the last follow-up, the flexion and extension of the affected elbow averaged 139.8° (from 125° to 160°), and the pronation-supination 177.9° (from 160° to 180°). The operation time averaged 77.8 min (from 40 to 135 min). Postoperative olecranon skin discomfort developed in 4 patients, 2 of whom underwent removal of internal fixation; no such complication as internal fixation breakage, screw loosening, incision infection or elbow stiffness was observed in the other 17 cases. At the last follow-up, the MEPS scores averaged 97.9 points (from 85 to 100 points) and the VAS scores 0.2 points (from 0 to 2 points).Conclusion:The sled board internal fixation can result in good therapeutic effects on the treatment of olecranon fractures.

Bilateral Transolecranon Fracture-Dislocation Elbow with Bilateral Coronoid and Radial Head Fractures – A Rare Complex Elbow Injury: A Case Report and Review of Literature

Bilateral olecranon fractures are a rare occurrence. Direct trauma usually results in comminuted fractures and indirect trauma in transverse fractures. We describe a case of bilateral olecranon fracture with a radial head comminuted fracture with coronoid fracture without the involvement of collaterals. Olecranon fractures are usually a result of direct trauma (fall from height/motor vehicle accidents) or indirect trauma. A 22year old male patient presented to the emergency department with complaints of pain and swelling around both elbows following a motor vehicle accident. The patient also sustained trauma to the head and had a history of transient loss of consciousness. CT brain at the time of presentation was normal and the patient was conscious. The Olecranon Fracture was fixed with a pre-contoured olecranon locking compression plate (Synthes, USA). In our case, the collaterals were intact and as the radial head was comminuted, we excised the radial head. The radial head being secondary stabilizer of the elbow in injuries to the medial collateral ligament complex. The excision of the radial head would not cause any instability. Bilateral olecranon fractures need to be fixed anatomically, the comminuted radial head was excised and the anterior capsule was repaired

Tratamiento para fractura de olécranon en pacientes mayores: Revisión sistemática / Treatment for olecranon fracture in older patients: Systematic review

Introducción El tratamiento de las fracturas de olécranon puede tener diferentes resultados, según el tipo de intervención, las características de la fractura y del paciente. Esta revisión sistemática de la literatura pretende identificar los tratamientos para el manejo de este tipo de fractura en el adulto mayor y sus resultados funcionales. Materiales y métodos Se realizó una búsqueda sistemática de la bibliografía en las bases de datos Medline, Embase y Cochrane. Se incluyeron estudios clínicos en pacientes mayores con fractura de olécranon que incluyeran resultados funcionales en sus seguimientos. Resultados De un total de 432 referencias capturadas, se incluyeron nueve estudios 6 estudios observacionales retrospectivos y 3 prospectivos. En 3 estudios se usó exclusivamente tratamiento no quirúrgico y en 4 tratamiento quirúrgico, de los cuales 2 comparan la fijación de banda de tensión con placa y 2 proponen el uso de supersuturas y suturas de anclaje. En 2 estudios comparan el tratamiento quirúrgico con el tratamiento no quirúrgico. En la evaluación de los resultados funcionales el puntaje de la Escala de Incapacidades del brazo, hombro y la mano (DASH) fue la más usada. Discusión En pacientes de edad avanzada antes de optar por fijación quirúrgica, se evalúan factores que pueden tener implicaciones en los resultados clínicos y funcionales como el número de comorbilidades y la mala calidad ósea. Este trabajo puede servir de base para la elección de tratamientos no quirúrgicos bajo condiciones requeridas, para obtener mejores resultados funcionales.

Background The treatment of olecranon fractures may lead to different outcomes, depending on the type of intervention, the characteristics of the fracture, and the patient. This systematic review of the literature aims to identify the treatments for the management of this type of fracture in the elderly and its functional results. Methods A systematic search of the bibliography was carried out in the Medline, Embase and Cochrane databases. It included clinical studies on elderly patients with olecranon fractures, as well as the functional results in their follow-up. Results Of a total of 432 references were obtained, with nine studies including 6 retrospective observational studies, and 3 prospective studies. In 3 studies, non-surgical treatment was used, and in 4 surgical treatments, 2 were comparing tension band wiring and plate fixation, and 2 proposed the use of super sutures and anchoring sutures. In 2 studies, surgical treatment was compared with non-surgical treatment. In the evaluation, the functional outcomes, the score of the Scale of disabilities of the arm, shoulder, and the hand (DASH) was the most used. Discussion In patients of advanced age, before opting for surgical fixation, factors that may have implications for clinical and functional outcomes, such as number of comorbidities and poor bone quality are evaluated. This work can serve as a basis for the choice of non-surgical treatments under the necessary conditions, and to obtain better functional results.

Fractura compleja de codo / Complex elbow fracture

Resumen: Las fracturas de codo son secundarias a traumatismos de baja y alta energía, afectan el extremo distal del húmero, olécranon, cabeza radial o una combinación de las anteriores. Las fracturas complejas de codo dificultan la reducción y su posterior fijación, lo que representa un reto para el ortopedista. Es esencial el uso de auxiliares diagnósticos como la tomografía axial computarizada para su diagnóstico y posterior tratamiento. En la actualidad, las nuevas tendencias en la fijación de las mismas y los diversos implantes con los que se cuenta pueden mejorar el pronóstico del paciente. Se presentan dos casos clínicos de fracturas complejas de codo tratadas mediante osteosíntesis.

Abstract: Elbow fractures are secondary to low or high energy trauma affecting the distal humerus, olecranon, radial head or a combination of the above. Complex fractures of the elbow complicate the reduction and its subsequent fixation representing a real challenge for the orthopedic surgeon. It is essential the use of diagnostic aids such as computerized axial tomography for diagnosis and subsequent treatment. Currently new trends in the fixation of the same and the various implants with which it is counted, can improve improve the patient's prognosis. We present two clinical cases of complex elbow fractures treated by osteosynthesis.

EFFECTIVENESS OF SHARP TEETH HOOK PLATE FOR TREATMENT OF OLECRANON FRACTURES / 中国修复重建外科杂志

OBJECTIVE: To investigate the effectiveness of sharp teeth hook plate by cutting for the treatment of olecranon fractures by comparison with Kirschner wire tension belt and locking plate. METHODS: Between January 2011 and April 2015, 32 cases of olecranon fractures were treated. Fracture was fixed with sharp teeth hook plate by cutting in 12 cases (trial group) and with Kirschner wire tension belt or locking plate in 20 cases (control group). There was no significant difference in gender, age, side and type of fracture, and time from injury to operation between 2 groups (P>0.05). The healing time of fractures and complications were recorded. At 1 year after operation, the subjective function results were evaluated according to Disability of Arm, Shoulder, and Hand (DASH) score, and objective function results by Mayo Elbow Score (MEPS); visual analogue scale (VAS) was used for elbow joint pain, and range of motion of flexion and extension of elbow joint was measured. RESULTS: All incisions healed by first intention, with no vascular and nerve injuries. All patients were followed up 12-36 months with an average of 18 months. All fractures healed, and there was no significant difference in the healing time between 2 groups (P>0.05). Loosening of Kirschner wire occurred in 2 cases of control group, but no loosening of internal fixation was observed in trial group after operation. There was no significant difference in the incidence of complications between 2 groups (P>0.05). The DASH, MEPS, VAS score, and range of motion of flexion in trial group were superior to those in control group, showing significant differences (P0.05). CONCLUSIONS: Sharp teeth hook plate for treatment of olecranon fractures overcomes the shortcomings that Kirschner wire tension is easy to slide and locking plate has a compression effect on triceps tendon, so it has good effectiveness.

Surgical Outcomes after Olecranon Plating with Retrograde Coronoid Process Screw Fixation through the Plate Hole in the Bifocal Fracture of the Proximal Ulna / 대한정형외과학회잡지

PURPOSE: Bifocal fracture of the proximal ulna is a fracture of the olecranon accompanied by fracture of the coronoid process. The purpose of the current study was to analyze the clinical results of the author's technique in bifocal fracture of the proximal ulna. MATERIALS AND METHODS: Fifteen patients (10 men, 5 women) treated at CHA Bundang Medical Center from April 2006 to October 2014 were analyzed retrospectively. All patients underwent internal fixation using a locking compression plate (LCP) with retrograde screw fixation of the coronoid process through a screw hole of the plate. Mean age of the patients was 42.6 years and the mean follow-up period was 18.6 months. Comminuted coronoid fractures with hard to screw fixation, complex injuries combined with open damage, and complete ligament rupture were excluded. Fracture union and articular congruity were examined on the follow-up radiographs. Range of motion, disability of the arm, shoulder and hand (DASH) score, and Mayo elbow performance score were evaluated for functional analysis. RESULTS: Fracture union was achieved and articular step off was less than 2 mm in all patients on the follow-up radiographs. The mean value of modified Mayo elbow score was 92.14 (80–100) and DASH score was 7.11 at last follow-up. The mean range of motion of elbow was 128o. There was one case of small heterotopic ossification as a radiographic complication which had no functional deficit. CONCLUSION: Internal fixation of bifocal multifragmentary articular fractures of the proximal ulna with anatomically contoured LCP olecranon plate and retrograde long screws could be a recommendable surgical procedure. This study showed that the precontoured plate with retrograde coronoid process screw fixation can produce good clinical and radiographic outcomes in bifocal fractures of the proximal ulna. We recommend this procedure in this type of fracture.

Tension band wiring of the olecranon: A biochemical study

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> Hardware prominence is the most common cause of reoperation in patients who have undergone tension band wiring for fractures of the olecranon. The study was conducted to compare the strength of four different constructs of tension band wiring of the olecranon.<br /><strong>METHODS:</strong> A transverse fracture was created in twenty cadaveric ulnas which were equally divided into four groups according to the method of fixation: 1-Single tension band, transcortical k-wire fixation; 2-Single tension band, intramedullary k-wire fixation; 3-Double tension band, transcortical k-wire fixation; 4-Double tension band, intramedullary k-wire fixation. All specimens were mounted on a universal testing machine using a custom-made fixation jig. They were tested under a single cycle load to failure. The maximum failure load was measured for all specimens.<br /><strong>RESULTS:</strong> There was no significant difference in the maximum load to failure among the four treatment groups.<br /><strong>CONCLUSION:</strong> No differences in the maximum load to failure noted in between treatment groups, regardless if single or double tension band wiring was done, and regardless if k-wire fixation was transcortical or medullary. These findings would support the argument that any of the desired fixation methods may be used.</p>

Tratamiento funcional de fracturas desplazadas de olécranon en pacientes mayores de 70 años / Functional treatment of displaced olecranon fractures in patients older than 70 years

Objetivo: Reportar los resultados clínicos y radiológicos del tratamiento funcional de fracturas desplazadas de olécranon en pacientes >70 años. Materiales y Métodos: Se evaluaron 28 pacientes >70 años con fracturas desplazadas de olécranon. El tratamiento consistió en la inmovilización inicial con una valva de yeso (promedio 5 días) y, luego, movilización activa según tolerancia. No se indicó rehabilitación kinesiológica. Ningún paciente fue perdido en el seguimiento. El grupo estaba formado por 27 mujeres y un hombre. La edad promedio era de 82 años. Según la clasificación de la Clínica Mayo, 18 fracturas eran de tipo IIA y 10, de tipo IIB. El seguimiento promedio fue de 14 meses. Resultados: La flexo-extensión fue de 142°-15°. La fuerza muscular fue de M5 en 17 pacientes y de M4 en 9. La fuerza de puño fue un 93% del lado contralateral. El dolor según la escala visual analógica fue de 1. La satisfacción con el tratamiento según esta escala fue de 9. Según el puntaje de la Clínica Mayo, 22 pacientes tuvieron resultados excelentes y 6, buenos. El puntaje DASH promedio fue de 15. Veinticuatro pacientes evolucionaron hacia la seudoartrosis. El gap articular final fue, en promedio, de 16 mm. El gap a nivel de la cortical posterior final fue, en promedio de 22 mm. Conclusión: El tratamiento no quirúrgico de las fracturas desplazadas de olécranon en pacientes mayores ofrece un número elevado de buenos resultados funcionales con alto grado de satisfacción. Nivel de evidencia: IV.

Objective: To report the clinical and radiological outcomes of the functional treatment for displaced olecranon fractures in patients >70 years old. Methods: Twenty-eight patients >70 years old with displaced olecranon fractures were evaluated. The treatment included initial immobilization with a cast (average time 5 days) and then active movement as tolerated. Physiotherapy was not indicated. No patients were lost in the follow-up. The study group included 27 women and a man. Average age was 82 years old. According to the Mayo Clinic Classification, 18 fractures were type IIA and 10 were type IIB. Average followup was 14 months. Results: Flexion-extension was of 142°-15°. Muscular strength of the triceps was M5 in 17 patients and M4 in 9. Grip strength was 93% of the contralateral side. The score in the visual analogue scale for pain was 1. Satisfaction with the treatment according to this scale was 9. According to the Mayo Clinic classification, 22 patients presented excellent results, and 6 good results. Average DASH score was 15. Twenty-four patients evolved to a nonunion. Mean final joint gap was 16 mm. Mean final gap at the posterior cortical level of the olecranon was 22 mm. Conclusion: Functional treatment of displaced olecranon fractures in patients >70 years old is associated with a high degree of goods results and patient satisfaction. Level of evidence. IV.

Progress on Diagnosis and Treatment of Ulna Coronoid Process Fractures / 中国微创外科杂志

[Summary] Ulna coronoid process fractures are not uncommon in clinical practice,but its treatment is difficult.Regan-Morrey type Ⅰ and Ⅱ fracture has no significant effect on the stability of the elbow joint,thus conservative treatment can be used.For some type Ⅱ fractures combined with elbow posterior dislocation,surgical treatment is required because of the potential danger of recurrent dislocation after reduction.Ulna coronoid process fractures often accompany other tissue injury,therefore manipulative reduction and external fixation with a cast or brace should be given as soon as possible.Once severe swelling complicated with bone fascia compartment syndrome,early decompression should be performed.The surgery can be carried out via medial approach,or in combination with lateral approach when lateral collateral ligament injury exists.Internal fixation materials include miniature titanium plate,micro screws,absorbable screws,hollow screw,anchor nail,external fixator and coronoid process of prosthetic replacement.

Fixation of Olecranon Fractures Using Plating System

PURPOSE: To evaluate the clinical and radiological outcomes of plate fixation for olecranon fractures which was difficult to be fixed firmly with tension band wiring alone. MATERIALS AND METHODS: From 1995 through 2008, 20 patients who underwent plate fixation of an olecranon fracture were included in this retrospective study. According to the Mayo classification, there were 3 type IIA fracture, 7 type IIB, and 10 type IIIB fractures. Clinical evaluation was done based on radiographic union of olecranon and measurements of range of motion at last follow-up. Disability of the arm, shoulder and hand (DASH) score and Mayo Elbow Performance score was used for evaluation of functional recovery. RESULTS: Union was achieved in 18 (90%) at an average of 5.6 months. The mean arc of elbow motion was 123degrees and the mean rotation arc was 81degrees. According to the MEPS, sixteen of twenty patients had a good or excellent outcome. The mean DASH score was 16.3. Most common complication was hardware irritation in 3 patients. CONCLUSION: Plate fixation is an effective treatment option for severe olecranon fracture pattern like comminuted fractures, Monteggia equivalent with unstable elbows and nonunions.

A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures / 대한정형외과학회잡지

PURPOSE: To analyze the clinical result of a contoured plate fixation using a bicortical screw and a double plate fixation in the surgical treatment of an adult's comminuted olecranon fracture. MATERIALS AND METHODS: A total of 22 patients were classified by Mayo classification as Type IIB (17) and Type IIIB (5). All patients enrolled in the study were treated between July 2002 and September 2009. Twelve patients were operated on using the contoured plate internal fixation using a bicortical screw procedure classified as group 'A'. The 10 patients operated on by a double plate fixation were classified as group 'B'. The Mayo elbow performance score was used to compare postoperative clinical results based on total points in 4 categories: pain, range of motion, articular stability, and articular function. RESULTS: The clinical results of using the Mayo elbow performance score of group 'A' were that 10 scored in the 'excellent' range and 2 scored in the 'good' range the following: in group 'B' were in the excellent range and 3 were in the good range. Both groups showed satisfactory results. Postoperative elbow exercises in group 'A' commenced 7.8 (5-14) days on average, postoperatively. For 'B' group, post-operative elbow exercises began 4.5 (3-7) days following the operation. With regard to the exercise and the range of elbow motion, group 'A' averaged 113.5 degrees and group 'B' averaged 112 degrees. After surgery, the average durations until the bone union were 3.8 (2.4-5.6) months for group 'A' and 4 (2.5-5) months for group 'B', respectively. CONCLUSION: There was no significant difference in the clinical results between patients treated with the contoured plate internal fixation using a bicortical screw or the internal fixation using a double plate in the surgical treatment of adults with comminuted olecranon fracture or dislocation. Therefore, both types of operative approach are acceptable.

Compartment Syndrome Following an Olecranon Fracture in a Stroke Patient Taking Ticlopidine and Aspirin

We report a case of compartment syndrome following an olecranon fracture in the stroke patient with quadriparesis taking ticlopidine and aspirin. Antithrombic and antiaggregating ability of the medications could increase the bleeding tendency. Intraoperatively, the deep fascia of the forearm was found to be thick and tight due to long-standing spasticity, which made it difficult to minimize increased intra-compartmental pressure due to the hemorrhage from the fracture site. The chronically spastic limb of the stroke patients taking ticlopidine and aspirin should be observed carefully for the occurrence of compartment syndrome even after a low energy injury.

Treatment of Ulnar Olecranon Fracture Using Acutrak Screw

PURPOSE: To evaluate the clinical results of Acutrak screw fixation for ulnar olecranon fractures. MATERIALS AND METHODS: We reviewed 15 cases of ulnar olecranon fractures which were treated with Acutrak screws from February 2003 to September 2007. Follow-up period is from 12 months to 42 months. We used Mayo classification. Radiologic results were analyzed according to step-off, gap, reduction loss, and functional results were analyzed according to pain and ROM. We analyzed union time, operation time, incision size and complications. RESULTS: In functional results, there were 3 good cases out of 3 Mayo type IA, 8 good cases and 2 fair cases out of 10 type IIA, 1 fair case and 1 poor case out of 2 type IIB. In radiologic results, there was 1 case of reduction loss. Average union time was 9.4 weeks, average operation time was 24 minutes and average incision size was 1.8 cm. CONCLUSION: We conclude that Acutrak screw fixation can be a treatment option for olecranon fracture of Mayo type IA and IIA.

Treatment of fractures of olecranon and internal or external malleolus by using needle wire nail amended tension band / 中国矫形外科杂志

[Objective]To explore improved operation treatment of fractures of olecranon and internal or external malleolus by fixing them internally with needle wire amend tension band.[Method]A total of 89 cases of olecranon fracture and 63 cases of internal and external malleolus fracture were treated by the amended traditional tension belt using needle wire nails.[Result]Sixty-eight and 55 of these cases(80.9%) had been followed-up respectively for 2.5 years in average,the longest follow-up period was 5 years and the shortest was 6 months.It shows through evaluation with Wolfgang post curative standard that 65 and 53 cases were excellent in curative effect(95.9%),3 and 2 cases had moderate result(4.1%),and there was no worse case.The average fracture cure time was 1.5 months.[Conclusion]The improvement of traditional tension belt in olecranon and internal or external malleolus fracture operation by using needle wire nails has the following advantages:(1)Simplifying operation procedures;(2)Reducing number of steel nails;(3)Keeping the biomechanical principle of the tension band and internal AO fixing advantage;(4)Reducing the phenomena of "tension loss" caused by expanded steel wire holes as a result of osteonecrosis,and avoiding internal loose complication.The disadvantage of this method is that the fixation has to be taken out through operation.

EXTERNAL FIXATION TREATMENT OF OLECRANON FRACTUREION WITH PRESSURE (A 94 CASES REPORT) / 解放军医学杂志

Objective To use external fixator in the treatment of fracture of the olecranon of ulna. Methods Ninety four cases of olecranon fracture were treated with external fixators. The lateral medial displacement was first reduced, followed by the reduction of the proximal fragments. In some difficult cases with comminated fracture, a Kirschner wire was inserted to lever the fracture fragments to proper site. The fragments were held together by two hands, and they were fixed with an external fixator with addition of longitudinal pressure. Results The mean healing time of all the 94 cases was 35 days (5 6 weeks), and the function of the elbow joint were restored to normal. Conculsion The method as described above is an easy, economical and safe method, and can be used in out patientdinic

Tardy Ulnar Nerve Palsy after Olecranon Fracture: 3 Cases Report / 대한정형외과학회잡지

There has not been reported that the tardy ulnar nerve palsy could be developed as a sequelae of the olecranon fracture. The purpose of this paper is to report our experience of diagnosis and treatment of tardy ulnar nerve palsy, developed in three patients who had managed for non-union and malunion of olecranon fractutre, with a review of the literature.