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

IF 1.7 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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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.