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Outcomes of embedded rafting k-wire technique for intermediate articular fragment fixation in comminuted olecranon fractures

  • Trauma Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background

Severely comminuted olecranon fractures are challenging injuries. Commonly used tension band wiring exerts excessive compressive forces causing olecranon shortening and joint incongruity. This study aimed to introduce the embedded rafting k-wire technique with the bridging technique for intermediate articular fragment fixation in comminuted olecranon fractures and evaluate its clinical and radiological outcomes.

Materials and methods

A total of 34 patients with comminuted olecranon fractures were treated with rafting k-wire fixation combined with a locking plate. Time to union, the number of rafting k-wires in the intermediate articular fragment, quality of joint reduction, and secondary reduction loss were analyzed. Elbow range of motion, Mayo Elbow Performance Score (MEPS), and complications were evaluated at the final follow-up.

Results

Fracture union was obtained in all patients. The mean number of intermediate articular fragments was 2.4 ± 0.7, and the average number of rafting k-wires was 3.0 ± 1.2. There were mild and moderate degree early posttraumatic osteoarthritis in 6 cases (17.6%) at the mean 20.8 months of follow-up. At the final follow-up, the mean range of elbow motion was 4.6° of flexion contracture and 133.5° of further flexion. The average MEPS was 97.1 (range, 75–100). Two patients had heterotrophic ossification without functional impairment.

Conclusion

The embedded rafting k-wire technique with bridging plates in comminuted olecranon fractures exhibited satisfactory outcomes. This method might serve as an alternative when considering the ability to restore articular congruency and stability in severely comminuted olecranon fragments.

Level of evidence

Level IV, therapeutic.

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Acknowledgements

The Institutional Review Board of Wonju Severance Christian Hospital approved this study (IRB No: CR320026).

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Authors and Affiliations

  1. Department of Orthopedic Surgery, Korea University Guro Hospital, Korea University Medicine, Seoul, Republic of Korea

    Jae-Woo Cho & Jong-Keon Oh

  2. Department of Orthopedic Surgery, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, 162 Ilsan-dong, 26426, Wonju, Republic of Korea

    Jaewoong Um & Hoon-Sang Sohn

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  1. Jae-Woo Cho
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Correspondence to Hoon-Sang Sohn.

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Cho, JW., Oh, JK., Um, J. et al. Outcomes of embedded rafting k-wire technique for intermediate articular fragment fixation in comminuted olecranon fractures. Arch Orthop Trauma Surg 142, 3327–3334 (2022). https://doi.org/10.1007/s00402-021-04166-7

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