Universität zu Köln

Ellwein, Alexander, Lill, Helmut, Warnhoff, Mara, Hackl, Michael, Wegmann, Kilian, Mueller, Lars-Peter, Gramlich, Yves, Hoffmann, Reinhard and Klug, Alexander ORCID: 0000-0002-2085-1545 (2020). Can low-profile double-plate osteosynthesis for olecranon fractures reduce implant removal? A retrospective multicenter study. J. Shoulder Elbow Surg., 29 (6). S. 1275 - 1282. NEW YORK: MOSBY-ELSEVIER. ISSN 1058-2746

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Abstract

Background: Because of poor soft-tissue coverage at the proximal ulna and prominent posteriorly positioned implants, hardware removal remains the most common reason for revision surgery of olecranon fractures that were operatively treated using plate osteosynthesis. We hypothesized that low-profile double-plate osteosynthesis would reduce the number of soft tissue-related hardware removals compared with single posterior plating whereas the functional results would be comparable. Methods: This study retrospectively included patients who were treated with low-profile double-plate osteosynthesis or a posterior 2.7-/3.5-mm locking compression plate (LCP) for isolated olecranon fractures from 3 study centers. In addition to the implant removal rate, functional outcome measures (range of motion; Mayo Elbow Performance Score; Disabilities of the Arm, Shoulder and Hand score) were statistically compared. Results: The study included 79 patients, with a mean follow-up period of 36 months (range. 24-77 months). Of these patients, 37 were treated with low-prolile double-plate osteosynthesis and 42, with a 2.7-/3.5-mm LCP. The mean age was 57 years (range, 18-93 years). Range of motion after treatment with low-profile double-plate osteosynthesis and a 2.7-/3.5-mm LCP measured 129 degrees (range, 80 degrees-155 degrees) and 139 degrees (range, 100 degrees-155 degrees), respectively. The Mayo Elbow Performance Scores were 95 (range, 65-100) and 99 (range, 85-100), respectively (P = .028), and the Disabilities of the Arm, Shoulder and Hand scores were 5.0 (range, 0-49) and 4.6 (range, 0-28), respectively (P = .67 3) . Hardware was removed in 32% and 50% of patients after treatment with double-plate osteosynthesis and a 2.7-/3.5mm LCP. respectively (P = .11). Hardware removal owing to soft-tissue irritation was noted in 27% of patients after double-plate osteosynthesis and 38% after LCP treatment (P = .30). Discussion: Low-profile double-plate osteosynthesis for treating olecranon fractures resulted in good clinical outcomes. However, the rate of hardware removal was not significantly reduced, and the functional results were comparable to those of common single posterior plate osteosynthesis. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ellwein, Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Lill, Helmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Warnhoff, Mara UNSPECIFIED UNSPECIFIED UNSPECIFIED Hackl, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Wegmann, Kilian UNSPECIFIED UNSPECIFIED UNSPECIFIED Mueller, Lars-Peter UNSPECIFIED UNSPECIFIED UNSPECIFIED Gramlich, Yves UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoffmann, Reinhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Klug, Alexander UNSPECIFIED orcid.org/0000-0002-2085-1545 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-332378
DOI:	10.1016/j.jse.2020.01.091
Journal or Publication Title:	J. Shoulder Elbow Surg.
Volume:	29
Number:	6
Page Range:	S. 1275 - 1282
Date:	2020
Publisher:	MOSBY-ELSEVIER
Place of Publication:	NEW YORK
ISSN:	1058-2746
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language TENSION-BAND; FIXATION Multiple languages Orthopedics; Sport Sciences; Surgery Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/33237