RESUMEN
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.
RESUMEN
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.