Olecranon fractures: An old fixation device for a new surgical technique.

M Scrivano, G Fedeli, S Porcino, E Sinno, A P Vadalà, A Clarioni, A Redler, D Perugia
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Abstract

Introduction: Internal fixation in not-comminuted oblique and transverse olecranon fractures is commonly performed with tension band wiring. However, despite its high healing rate, this technique is associated with a high rate of complications, often requiring the removal of fixation devices in up to 80 % of cases. The aim of our study was to describe a surgical technique using eyelet pins that maintains the effectiveness of the classic tension band wiring while reducing intolerance or displacement of the fixation devices.

Methods: Fifteen patients with surgically treated Mayo type II A or II B olecranon fractures, meeting the inclusion criteria, were enrolled. Clinical and functional assessments were conducted using MEPS and DASH scores at the 12 month follow-up. Additionally, complications and the duration of the operation were documented.

Results: Fifteen patients were enrolled, with eight having type II A and seven having type II B olecranon fractures. The mean patient age was 46.8 years, including ten males and five females. Nine cases involved the right side, while six involved the left. At the 12-month follow-up, the mean MEPS score was 98/100, and the DASH score was 9. Two patients (13.3 %) experienced superficial wound infections, and two (13.3 %) had persistent pain at the triceps tendon insertion site. No cases required removal of fixation devices.

Conclusion: The eyelet pin system was found to be a safe and effective method for reducing and fixing olecranon fractures. Based on a limited series, this new technique exhibits the same reliability and reproducibility as tension band wiring but with a lower rate of complications.

骨骺骨折:新手术技术的旧固定装置
导言:非粉碎性斜行和横行肩胛骨骨折的内固定通常采用张力带接线法。然而,尽管这种技术的愈合率很高,但其并发症的发生率也很高,在多达 80% 的病例中往往需要移除固定装置。我们的研究旨在描述一种使用孔眼针的手术技术,它既能保持传统张力带接线的有效性,又能减少固定装置的不耐受或移位:15名符合纳入标准的梅奥II A型或II B型肩胛骨骨折患者接受了手术治疗。在12个月的随访中,使用MEPS和DASH评分进行临床和功能评估。此外,还记录了并发症和手术持续时间:15名患者中,8人属于II A型,7人属于II B型肩胛骨骨折。患者平均年龄为 46.8 岁,其中男性 10 人,女性 5 人。九例涉及右侧,六例涉及左侧。在12个月的随访中,平均MEPS评分为98/100,DASH评分为9分。两名患者(13.3%)出现表皮伤口感染,两名患者(13.3%)肱三头肌腱插入部位持续疼痛。没有病例需要移除固定装置:结论:眼钉系统是减少和固定肩胛骨骨折的一种安全有效的方法。根据有限的系列研究,这项新技术与张力带接线具有相同的可靠性和可重复性,但并发症发生率较低。
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