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Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications

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Abstract

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 < 0.05) between fracture type and the osteoarthritis.

Conclusions

In olecranon fractures, good functional and radiological results with low complications are predictable. The osteoarthritis is possible in more complex fractures and with other associated fractures.

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Authors and Affiliations

  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

    Juan Martín Patiño, Alejandro F. Rullan Corna, Alejandro E. Michelini, Ignacio M. Abdon & Bruno Marinucci

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  1. Juan Martín Patiño
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  2. Alejandro F. Rullan Corna
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  3. Alejandro E. Michelini
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  4. Ignacio M. Abdon
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  5. Bruno Marinucci
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Correspondence to Juan Martín Patiño.

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Our institutional ethics committee approved this study.

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All contributing authors perform their activity in Hospital Militar Central, Cirujano Mayor Cosme Argerich, Buenos Aires, Argentina, Departamento de Ortopedia y Traumatología, Sección de hombro y codo, Servicio de Cirugía de la Mano y miembro superior

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Patiño, J.M., Rullan Corna, A.F., Michelini, A.E. et al. Olecranon fractures: do they lead to osteoarthritis? Long-term outcomes and complications. International Orthopaedics (SICOT) 44, 2379–2384 (2020). https://doi.org/10.1007/s00264-020-04695-7

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