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Fracture line distribution of olecranon fractures

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

Abstract

Purpose

The association between specific olecranon fracture characteristics (e.g., displacement, fragmentation, subluxation) and fracture line distribution might help surgeons predict intra-articular fracture location based on fracture characteristics that can be determined on radiographs. We hypothesized that fracture mapping techniques would reveal different fracture patterns for minimally displaced fractures, displaced fractures, and fracture–dislocations of the olecranon.

Methods

A consecutive series of 78 patients with olecranon fractures were evaluated using initial radiographs and computed tomography scans and characterized according to the Mayo classification. Fracture lines were identified based on reduced three-dimensional computed tomography reconstructions and graphically superimposed onto a standard template to create two-dimensional fracture maps. The fracture maps were then converted into fracture heat maps. Based on fracture and heat maps, fracture line location and patterns were determined.

Results

Six (7.7%) patients had a non- or minimally displaced fracture, 22 (28%) a displaced fracture, and 50 (64%) a fracture–dislocation of the olecranon. There were 27 (54%) anterior and 23 (46%) posterior olecranon fracture–dislocations. Fracture lines of non- or minimally displaced fractures and posterior fracture–dislocations enter and exit the trochlear notch at the base of the coronoid, while fracture lines of displaced fractures and anterior fracture–dislocations were spread more broadly over the depths of the trochlear notch.

Conclusions

Based on fracture characteristics depicted on radiographs, one can anticipate the amount of the olecranon involved (how close is the fracture line to the coronoid) and the orientation of the fracture line. Computer tomography could be reserved for when more specific knowledge of the fracture line might affect treatment.

Level of evidence: III.

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Authors and Affiliations

  1. Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Harvard Medical School, Boston, USA

    Bart Lubberts, Jos J. Mellema & Stein J. Janssen

  2. Massachusetts General Hospital, Harvard Medical School, Boston, USA

    David Ring

  3. Dell Medical School, University of Texas at Austin, Austin, USA

    David Ring

Authors
  1. Bart Lubberts
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  2. Jos J. Mellema
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  3. Stein J. Janssen
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  4. David Ring
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Corresponding author

Correspondence to David Ring.

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Conflict of interest

Dr. Ring has received honoraria from AO North America, AO International and various Hospitals and Universities, receives royalties from Wright Medical, and Skeletal Dynamics. Dr. Ring is Deputy Editor for Hand and Wrist, Journal of Orthopaedic Trauma, Deputy Editor for Hand and Wrist, Clinical Orthopaedics and Related Research, and Assistant Editor, Journal of Shoulder and Elbow Surgery. For the remaining authors none were declared.

Funding

There is no funding source.

Ethical approval

This retrospective study was approved by our Institutional Review Board (Protocol No. 2009P001019/MGH).

Informed consent

Informed consent was not necessary for the study.

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Lubberts, B., Mellema, J.J., Janssen, S.J. et al. Fracture line distribution of olecranon fractures. Arch Orthop Trauma Surg 137, 37–42 (2017). https://doi.org/10.1007/s00402-016-2593-7

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  • DOI: https://doi.org/10.1007/s00402-016-2593-7

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