Intramedullary Screw Fixation of Olecranon Fractures Reduces the Risk of Early Unplanned Reoperation: A Retrospective Review of 556 Patients. Issue 1 (January 2022)

• Record Type: Journal Article
• Authors: Meals, Clifton; Johnson, Christopher; Reitz, Logan; Hannan, Zachary; Mulliken, Alexandra; O'Hara, Nathan N.; Pensy, Raymond
• Is Part Of: Journal of orthopaedic trauma. Volume 36:Issue 1(2022)
• Page Start: e24
• Page End: e29
• Publication Date: 2022-01
• Subjects: olecranon -- fracture -- plate -- intramedullary -- screw -- tension band -- reoperation; Orthopedics -- Periodicals; Wounds and injuries -- Periodicals; Orthopedics -- Periodicals; Wounds and Injuries -- therapy -- Periodicals; Periodicals; 617.47044
• DOI: 10.1097/BOT.0000000000002145
• Languages: English
• ISSNs: 0890-5339

Abstract

Abstract : Objectives: To determine the effect of intramedullary screw–based fixation on early postoperative complications after olecranon fractures. We hypothesized that intramedullary screw–based fixation results in decreased need for reoperation compared with plate and screw–based and tension band–based fixation. Design: Retrospective cohort. Setting: Two academic Level-1 trauma centers. Patients/Participants: Five hundred fifty-six patients treated with a tension band–based, plate and screw–based, or intramedullary screw–based construct for an olecranon fracture over a 10-year period. Intervention: Open reduction and internal fixation. Main Outcome Measurement: Unplanned reoperation. Demographic, injury type and severity, supplemental fixation, and length of follow-up data were viewed as potential confounders and analyzed as such. Results: We identified 556 relevant patients. One hundred ninety-nine patients were treated with an intramedullary screw–based construct, 229 with a plate and screw–based construct, and 128 with a tension band–based construct. We observed significant differences in the age, fracture type, percentage of open fractures, use of supplemental fixation, and treating institution between the treatment groups. Ninety-five patients (17.1%) had an unplanned reoperation. When we adjusted for confounders, intramedullary screw–based fixation reduced the odds of an unplanned reoperation by 54% compared with plate and screw–based treatment. In the adjusted analysis, we did not observe a difference between plate and screw–based treatment and tension band–based fixation. Conclusions: Intramedullary screw–based fixation of olecranon fractures results in decreased need for early reoperation compared with more common olecranon fixation strategies. Level of Evidence: Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.