Ruben García-Elvira1, Maria Antonia Vives-Barquiel2, Pilar Camacho-Carrasco2, Jose Roberto Ballesteros-Betancourt2, Raquel García-Tarriño2, Anna Domingo-Trepat2, J Ríos Guilermo3, Andreu Combalia Aleu4. 1. Hospital Clínic de Barcelona. Orthopaedic and Traumatology Department. Barcelona, Catalonia, Spain. Electronic address: rubengarciaelvira@gmail.com. 2. Hospital Clínic de Barcelona. Orthopaedic and Traumatology Department. Barcelona, Catalonia, Spain. 3. Medical Statistics Core Facility, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS) and Hospital Clinic, Barcelona, Spain. Biostatistics Unit, Faculty of Medicine, Universitat Autònoma de Barcelona, Spain. 4. Hospital Clínic de Barcelona. Orthopaedic and Traumatology Department. Barcelona, Catalonia, Spain; Head of Orthopaedic and Traumatology Department. Hospital Clínic Barcelona, Instituto de Investigación August Pi i Sunyer - IDIBAPS, Universidad de Barcelona, Spain.
Abstract
BACKGROUND: The aim of this study is to assess the causes and rates of re-operation in olecranon fractures in adults treated with transosseous suture. METHODS: We prospectively recruited 29 patients who were treated with this technique between 2010 and 2018. The type of suture used, tourniquet time and surgical time were analyzed for each one. X-rays were taken after 2 weeks, 6 weeks and 6 months, recording complications, causes, rates of re-operation and the final clinical condition. RESULTS: Median time for ischemia and surgery were 51 (95% CI:48;62) and 45 (95% CI:42;55) minutes respectively. The radiologic studies showed diastasis of the posterior cortex in the X-rays taken after 2 weeks and after 6 weeks in 7 (24,1%) cases. Of these cases, two (6,8%) were no longer followed-up after 6 months. There was only one case of aseptic non-union. Among these cases, two patients (6.8%) required surgical debridement due to acute soft tissue infection. No complication had any clinical impact, maintaining all patients full range of motion and no pain. Osteosynthesis removal was not necessary in any case. CONCLUSION: Transosseous suture with high strength thread is a valid alternative for treating Mayo IIA olecranon fractures in adult patients, decreasing re-operation rates for implant removal. There may be, in a moderate percentage of cases, radiologic diastasis of the posterior cortex at the fracture site, without causing pain nor limiting mobility LEVEL OF EVIDENCE: III.
BACKGROUND: The aim of this study is to assess the causes and rates of re-operation in olecranon fractures in adults treated with transosseous suture. METHODS: We prospectively recruited 29 patients who were treated with this technique between 2010 and 2018. The type of suture used, tourniquet time and surgical time were analyzed for each one. X-rays were taken after 2 weeks, 6 weeks and 6 months, recording complications, causes, rates of re-operation and the final clinical condition. RESULTS: Median time for ischemia and surgery were 51 (95% CI:48;62) and 45 (95% CI:42;55) minutes respectively. The radiologic studies showed diastasis of the posterior cortex in the X-rays taken after 2 weeks and after 6 weeks in 7 (24,1%) cases. Of these cases, two (6,8%) were no longer followed-up after 6 months. There was only one case of aseptic non-union. Among these cases, two patients (6.8%) required surgical debridement due to acute soft tissue infection. No complication had any clinical impact, maintaining all patients full range of motion and no pain. Osteosynthesis removal was not necessary in any case. CONCLUSION: Transosseous suture with high strength thread is a valid alternative for treating Mayo IIA olecranon fractures in adult patients, decreasing re-operation rates for implant removal. There may be, in a moderate percentage of cases, radiologic diastasis of the posterior cortex at the fracture site, without causing pain nor limiting mobility LEVEL OF EVIDENCE: III.