OUTCOMES OF ALL-SUTURE TENSION BAND TECHNIQUE FOR FIXATION OF OLECRANON FRACTURES: A RETROSPECTIVE CASE SERIES
Notice bibliographique
Résumé
Olecranon fractures are a common orthopedic injury that account for approximately 10% of upper extremity injuries. These injuries have a bimodal distribution with the high energy injuries primarily affecting a younger population and low energy falls affecting the elderly. Tension band wiring is one of the earliest and most common techniques for the fixation of olecranon fractures. Tension band wiring has been shown to result in good functional outcomes but has been fraught with complications related to hardware migration and irritation. Reoperations rates after tension band wiring have been reported as 33.3%-79.2%. Although low-profile, pre-contoured plates have improved the hardware-related complications compared to tension band wiring, hardware removal secondary to plate irritation is still not that uncommon with reported rates ranging from 15%-56%. All-suture tension band technique is a novel technique for fixation of select olecranon fractures which have been shown to have equivalent or superior biomechanical performance to tension band wiring and avoid its hardware-related complications. However, outcomes of this fixation technique are not yet well-reported.The goal of this study was to evaluate the clinical and radiographic outcomes of patients who underwent all-suture tension band fixation of their olecranon fractures. This study was a retrospective case series of 15 patients with transverse olecranon fracture who underwent all-suture tension band fixation. The operated extremity was placed in a sling after the operation which was removed at the first postoperative visit (~2 weeks postoperatively) and the patients were allowed to work on range of motion (ROM) as tolerated. ROM at 6 weeks and at the time of final follow-up as well as the rate of union were evaluated. Patients charts and perioperative radiographs were evaluated for any complications including but not limited to infection, neurovascular injury, and any reoperations were also recorded, patients reported outcomes were collected prospectively post-operatively using PREE, qDASH and SANE scores. The mean age of patients in our cohort was 55±14, 66% were females. Our average follow-up time was 5±5 months. The patients achieved an average elbow arc of motion of 108°±28° at 6 weeks (extension -21°±8°; flexion 129°±23°) which improved to 133°±13° at the final follow-up (extension -13°±8°; flexion 146°±6°). They also achieve an average forearm arc of rotation of 156°±9° at 6 weeks (supination 80°±7°; pronation 76°±10°) and 157°±8° at the final follow-up (supination 83°±7°; pronation 74°±6°). At the time of final follow-up, patients reported average PREE of 15.8±5.1, qDASH of 10.1±10.2, and SANE score of 93.8±7.6. All patients achieved clinical and radiographic union by the final follow. No clinical or radiographic complications or reoperations were noted during the follow-up period. All-suture tension band technique is a viable option for the management of simple olecranon fractures or fractures with minimal comminution that can be converted to a simple fracture pattern. This technique yields excellent clinical outcomes and avoid hardware related complications associated with tension band wiring and plate fixation. There were no cases of nonunion or reoperation in our cases series. Larger cohorts and randomized clinical trials are needed to confirm these findings.
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Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,000 | 0,000 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,000 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,000 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».