Treatment of Sagittal Split Olecranon Fractures Using Dorsal Plates Combined With Tension Band Wiring or Cerclage Wires

Abstract

We evaluated the results of olecranon fractures with an intra-articular sagittal plane fracture treated by dorsal plates in combination with tension band wiring or cerclage wires. We included patients with comminuted olecranon fractures with sagittal split treated with combination fixation. Postoperative functional assessment, Mayo Elbow Performance Score (MEPS) and complications were recorded. The mean age of patients was 52 years (SD±16). There were 7 female and 5 male patients. There were 2 1B, 7 2B, and 3 3B fractures according to Mayo classification. All patient’s fractures healed satisfactorily. There was one minor skin breakdown, which we managed conservatively. The most common problem was symptomatic hardware, which led us to implant removal surgery (33%). Mean loss of motion for the elbow and forearm were as follows: extension 7.5 degrees (SD±5.8 degrees), flexion 9.5 degrees (SD±3.9 degrees), pronation 4.5 degrees (SD±3.3 degrees), and supination 5 degrees (SD±3.7 degrees). The mean MEPS score was 93.7 (SD±7.7). We successfully treated these challenging fractures with our combination fixation technique in our case series. Level of Evidence: Level IV—diagnostic case series.