Midterm outcomes of suture anchor fixation for displaced olecranon fractures.

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Abstract

Conflict of interest statement: Conflict of interest JAA would like to disclose royalties from: DJO Global, Zimmer-Biomet, Smith and Nephew, Stryker, Globus Medical, Inc., Slack Orthopedics, OsteoCentric Technologies, Bioventus; research support as a PI from: Lima Corporation - Italy, Orthofix, Arthrex, OREF, Department of Defense; Stock ownership: Shoulder JAM LLC, Marlin Medical Alliance LLC, Aevumed, Oberd, OTS Medical; Royalties, financial or material support from publishers: Wolters Kluwer; and board member/committee appointments for a society: Mid Atlantic Shoulder and Elbow Society, American Shoulder and Elbow Society, Shoulder360, Pacira. 16. Orthop Surg. 2020 Oct;12(5):1439-1447. doi: 10.1111/os.12765. Epub 2020 Sep 26. Surgical Treatment of Comminuted Coronal Shear Fracture of Distal Humerus. Teng L(1), Zhong G(2). Author information: (1)Department of Orthopedics, The First People's Hospital in Shuangliu District/West China Airport Hospital, Sichuan University, Chengdu, China. (2)Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, China. OBJECTIVE: To investigate the surgical approach, fixation, and clinical effect of comminuted coronal shear fracture of distal humerus. METHODS: From March 2017 to February 2019, we had used open reduction and internal fixation to treat 19 cases of comminuted distal humeral coronal shear fracture. There were 8 males and 11 females, with an average age of 44.6 years (19-72 years). There were 10 cases on left side and 9 cases on right side. All cases were closed fractures. According to Dubberley's classification, there were six cases of type 1, six cases of type 2, and seven cases of type 3. The lateral Kocher approach, extended Kocher approach, extended Kocher approach combined with a medial incision and the olecranon osteotomy approach were used for exposure. Headless screw, Kirschner wire, and suture were used to fix the fractures. Two cases were fixed with hinged elbow fixators additionally. The follow-up was evaluated by Mayo Elbow Performance Score (MEPS). RESULTS: All patients were followed up for an average of 17.1 months (range, 12 to 30 months). The average time of fracture union was 8.8 ± 1.9 weeks. There were three cases of degenerative osteoarthritis of elbow and one case of heterotopic ossification after operation. A total of 10 patients underwent removal of implants. At the last follow-up, the elbow flexion-extension arc was 130.5° ± 10.5°. The forearm rotation arc was 167.4° ± 6.1°. The MEPS was 85.8 ± 8.5, the results were classified as excellent in nine cases, good in eight, and fair in two. The excellent and good rate was 89.5%. The time of fracture union of type 1 was shorter than type 3 (P = 0.024), the elbow flexion- extension arc of type 1 fracture was better than type 2 (P = 0.043) and type 3 (P = 0.012), the forearm rotation arc of type 1 fracture was better than type 3 (P = 0.006), the MEPS of type 1 fracture was better than type 2 (P = 0.009) and type 3 (P = 0.002). CONCLUSION: Open reduction and internal fixation with headless screw, Kirschner wire, and suture can be used for the treatment of comminuted distal humeral coronal shear fractures. The elbow joint function can be restored satisfactorily. © 2020 The Authors. Orthopaedic Surgery published by Chinese Orthopaedic Association and John Wiley & Sons Australia, Ltd. DOI: 10.1111/os.12765 PMCID: PMC7670145