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Évaluation clinique de l’ostéosynthèse par double plaque dans les fractures de l’olécrane : étude rétrospective cas contrôle - 05/12/19

Clinical evaluation of double plate osteosynthesis for olecranon fractures: A retrospective case-control study

Doi : 10.1016/j.rcot.2019.10.010 
Alexander Ellwein a, b, , Konstantinos Argiropoulos b, Rony-Orijit DeyHazra b, Marc-Frederic Pastor a, Tomas Smith a, Helmut Lill b
a Department for Orthopaedic Surgery, Medical School Hannover, Diakovere Annastift, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany 
b Department for Orthopaedic Surgery and Traumatology, Diakovere Friederikenstift, Humboldtstr. 5, 30169 Hannover, Germany 

Auteur correspondant. Department for Orthopaedic Surgery, Medical School Hannover, Diakovere Annastift, Anna-von-Borries-Straße 1-7, 30625 Hannover, Germany.Department for Orthopaedic Surgery, Medical School Hannover, Diakovere AnnastiftAnna-von-Borries-Straße 1-7Hannover30625Germany

Abstract

Introduction

Single, dorsal plating is a commonly used technique for treating olecranon fractures. Double-plate osteosynthesis is an alternative treatment. Aim of this study was to present the surgical technique using this novel double-plate implant for olecranon fractures and review clinical results, complication rates and revision surgeries. Results were compared to single, dorsal plating.

Hypothesis

Does double-plate osteosynthesis for olecranon fractures improve material's tolerance with respect to osteosynthesis by single dorsal plating?

Patients and methods

Between February 2011 and March 2015 we retrospectively evaluated 47 patients who were included in this study: 25 were treated with a low-profile double-plate osteosynthesis and 22 with an anatomically pre-shaped 3.5-mm locking compression plate (LCP). The 2 groups were the result of a change of implants in our department in 2013. Patient satisfaction, range of motion, patient related outcome scores (Mayo Elbow Performance Score [MEPS], Disabilities of Arm, Shoulder and Hand Score [DASH]), complications and revision surgeries were evaluated. Results between both implant types were statistically compared using the Mann-Whitney U test.

Results

After a mean follow-up of 41 months (range: 25–61) the low-profile double-plate group showed a range of motion of 127°, MEPS of 94 and DASH of 6. The 3.5-mm LCP group was found to have a range of motion of 130°, MEPS of 96 and DASH of 8. No clinical difference was found between groups. A total of 9 revision surgeries after double-plate osteosynthesis were recorded including seven implant removals and two intraarticular screws. One loosening of a screw without revision surgery was reported. The 3.5-mm LCP group had 9 revision surgeries including eight implant removals and one intraarticular screw.

Discussion

Low-profile double-plate osteosynthesis is a safe and effective alternative treatment of olecranon fractures. Subjective and objective clinical outcome measures revealed a low complication rate and excellent results. Still, implant removal due to soft tissue irritation remains an issue. These findings were comparable to common dorsal plate osteosynthesis.

Level of evidence

III, retrospective case-control study.

Il testo completo di questo articolo è disponibile in PDF.

Keywords : Olecranon fracture, Double-plate osteosynthesis, Low-profile, LCP, Complication



 Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.


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Vol 105 - N° 8

P. 1042 - dicembre 2019 Ritorno al numero
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