Treatment of comminuted olecranon fractures with olecranon plate and structural iliac crest graft


Published online: Dec 27 2012

Javier CERVERA-IRIMIA, Félix TOMÉ-BERMEJO, María A. GÓMEZ-BERMEJO, Esperanza HOLGADO-MORENO, Enrique GARRIDO STRATENWERTH

From the Department of Orthopaedic Surgery and Traumatology, Virgen de la Salud Hospital, Toledo, Spain

Abstract

Severely comminuted olecranon fractures are challenging injuries. Commonly used tension band wiring exerts excessive compressive forces causing olecranon shortening, joint incongruity and humeral trochlea subluxation. We report a retrospective study of 3 patients who underwent surgery for a severely comminuted olecranon fracture, with open reduction and fixation with a bridging rigid locking plate and intercalary tricortical structural iliac bone graft. Joint stability was restored allowing early mobilization and good functional outcome. Patients' mean age was 54 years. Mean follow-up was 23 months (range 19 to 27). Mean time to fusion was 14 weeks (range 11 to 18). Results were excellent/good in all three patients according the Broberg and Morrey scoring system, and Mayo Elbow Performance Index. Mean range of flexion was 115°, with an average loss of 20° of extension. Average pronation was 71°, and supination 80°.