Trans-olecranon fracture-dislocation of the elbow in children.

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Abstract

[Indexed for MEDLINE] 5. Int Orthop. 2020 Nov;44(11):2379-2384. doi: 10.1007/s00264-020-04695-7. Epub 2020 Jul 9. Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications. Patiño JM(1), Rullan Corna AF(2), Michelini AE(2), Abdon IM(2), Marinucci B(2). Author information: (1)Sección de Hombro y Codo, Servicio de Cirugía de la Mano y miembro superior, Departamento de Ortopedia y Traumatología, Hospital Militar Central. Cirujano Mayor Cosme Argerich, Luis Maria Campos Av. 726 piso 6, C1426BOS, Buenos Aires City, Argentina. drpatinojm@gmail.com. (2)Sección de Hombro y Codo, Servicio de Cirugía de la Mano y miembro superior, Departamento de Ortopedia y Traumatología, Hospital Militar Central. Cirujano Mayor Cosme Argerich, Luis Maria Campos Av. 726 piso 6, C1426BOS, Buenos Aires City, Argentina. PURPOSE: To report radiologic, functional outcomes, and complications with a long-term follow-up in acute olecranon fractures treated with osteosynthesis and, secondly, to determine the predisposing factors to arthritis. METHODS: Forty-two patients treated with osteosynthesis for acute olecranon fractures were reviewed, with a minimum follow-up of 24 months. Radiological and clinical evaluations including DASH, MEPS, active range of motion, pain, arthritis, associated lesions, and complications were recorded. Arthritis was classified according to Broberg-Morrey scale. A logistic regression model was estimated to determine risk factors to develop ulnohumeral arthritis. The association between the types of fractures according to Mayo classification and MEPS, and the association between the type of fracture and the presence of pain were analyzed. RESULTS: The average follow-up was of 43.64 months. The flexion-extension average range was 135.6°, and the mean MEPS was 89.45; the DASH was 25.26. Eighteen cases (42.86%) were fixed with pre-contoured locking plates, 21 with tension band wiring (50%), and 3 with cannulated screws of 7 mm (7.14%). Six cases (14.29%) needed hardware removal. All fractures healed. Ulnohumeral osteoarthritis was observed in 14 cases (33.3%). We did not find a significant association among the MEPS, pain, and the fracture type, according to Mayo (p > 0.1 for both values). A significant association was found (p