Complications Associated with Surgical Management of Olecranon Fractures: A Systematic Review.

IF 2.4 Q2 SURGERY

JBJS Reviews Pub Date : 2025-03-25 eCollection Date: 2025-03-01 DOI:10.2106/JBJS.RVW.24.00163

Mikhail A Bethell, Eoghan T Hurley, Harvey Allen, Jay M Levin, Christopher S Klifto, Oke Anakwenze, Malcolm R DeBaun, Christian A Péan

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引用次数: 0

Abstract

Purpose: The purpose of this study was to systematically review the literature to assess surgical complications following surgical management of olecranon fractures.

Methods: A literature search of MEDLINE, Embase, and the Cochrane Library was performed based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Clinical studies reporting complications following olecranon fracture management were included. The complication profile of plate fixation (PF), screw fixation, and tension band wiring (TBW) was recorded. Implant removal rates were considered independent of complication rates.

Results: Eighty-six studies were included in the analysis, with 5,161 patients who underwent an olecranon fracture treatment with an average age of 50.2 years (range, 7.4-88.8) and an average follow-up of 30.8 months (range, 3-218). The majority of studies used PF (58.1%). Screw fixation had higher implant complications than PF (5.9% vs 3.0%, p < 0.001), and PF had the highest percentage of musculoskeletal complications (3.6%, p <0.001) and wound complications (4.8%, p = 0.048). Nerve complications were similar among the 3 surgical options (p = 0.233). PF had the lowest complication rate (12.6%, p < 0.001), while screw fixation had the lowest reoperation (8.6%, p < 0.001) and implant removal rates (6.2%, p < 0.001). The overall complication rate for TBW was 18.4%, with loss of reduction being the most common complications occurring in 2.8% of patients.

Conclusion: PF demonstrated lower overall complications compared with screw fixation, with increased rates of symptomatic implants requiring removal which contributed to higher reoperation rates. TBW demonstrated an inferior complication profile compared with both modern fixation options. Further research should expand on the limited comparative studies between screw and PF.

Level of evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.

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鹰嘴骨折手术治疗的并发症：系统回顾。

目的：本研究的目的是系统地回顾文献，以评估手术治疗鹰嘴骨折后的手术并发症。方法：根据系统评价和meta分析指南的首选报告项目，对MEDLINE、Embase和Cochrane图书馆进行文献检索。临床研究报告了鹰嘴骨折处理后的并发症。记录钢板固定（PF）、螺钉固定和张力带钢丝（TBW）的并发症情况。种植体移除率与并发症发生率无关。结果：86项研究纳入分析，5161例患者接受鹰嘴骨折治疗，平均年龄50.2岁（范围7.4-88.8），平均随访时间30.8个月（范围3-218）。大多数研究使用PF（58.1%）。螺钉固定的植入物并发症高于PF (5.9% vs 3.0%, p < 0.001)， PF的肌肉骨骼并发症比例最高（3.6%,p）。结论：与螺钉固定相比，PF的总体并发症更低，有症状的植入物需要移除的比例增加，这有助于更高的再手术率。与两种现代固定方式相比，TBW表现出较低的并发症。进一步的研究应扩大螺钉与pf之间有限的比较研究。证据水平：治疗性III级。有关证据水平的完整描述，请参见作者说明。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

JBJS Reviews SURGERY-

CiteScore

4.40

自引率

4.30%

发文量

132

期刊介绍： JBJS Reviews is an innovative review journal from the publishers of The Journal of Bone & Joint Surgery. This continuously published online journal provides comprehensive, objective, and authoritative review articles written by recognized experts in the field. Edited by Thomas A. Einhorn, MD, and a distinguished Editorial Board, each issue of JBJS Reviews, updates the orthopaedic community on important topics in a concise, time-saving manner, providing expert insights into orthopaedic research and clinical experience. Comprehensive reviews, special features, and integrated CME provide orthopaedic surgeons with valuable perspectives on surgical practice and the latest advances in the field within twelve subspecialty areas: Basic Science, Education & Training, Elbow, Ethics, Foot & Ankle, Hand & Wrist, Hip, Infection, Knee, Oncology, Pediatrics, Pain Management, Rehabilitation, Shoulder, Spine, Sports Medicine, Trauma.