ABSTRACT
Forty-one adult patients with displaced olecranon fractures were treated with open reduction internal fixation in a prospective, randomized study comparing tension band wiring (TBW) and plate fixation (PF). Plate fixation required longer operative time, but did not lead to an increased complication rate. Range of elbow motion at six months did not differ significantly between the two groups. Symptomatic metal prominence was frequently observed after TBW (42%), although true Kirschner wire (K-wire) migration was seen in only one patient. Postoperative loss of reduction, leading to a significant articular step-off or gap, was more frequent after TBW (53%) than after PF (5%). Tension band wiring resulted in 37% good clinical and 47% good roentgenographic results, as compared with PF, which resulted in 63% good clinical and 86% good roentgenographic results. Plate fixation should be carefully considered when planning open reduction and internal fixation of displaced olecranon fractures.
Subject(s)
Bone Plates , Bone Wires , Ulna Fractures/surgery , Adolescent , Adult , Aged , Elbow Joint/physiology , Female , Humans , Male , Middle Aged , Prospective Studies , Radiography , Range of Motion, Articular , Ulna Fractures/diagnostic imagingABSTRACT
Active ranges of motion of the joints of the hand are well documented, but there is little data reporting the functional ranges of motion required to perform activities of daily living. Electrogoniometric and standard methods were used to measure both active and functional ranges of motion of the metacarpalphalangeal and interphalangeal joints during 11 activities of daily living. In the fingers, only a small percentage of the active range of motion of the joints was required for functional tasks. Functional flexion postures averaged 61 degrees at the metacarpalphalangeal joint, 60 degrees at the proximal interphalangeal joint, and 39 degrees at the distal interphalangeal joint. In the thumb, functional flexion postures averaged 21 degrees at the metacarpalphalangeal joint and 18 degrees at the interphalangeal joint using only 32% of the available flexion. Active thumb metacarpalphalangeal joint motion was found to be bimodal in the study group.