Comminuted fractures of the olecranon treated by the Weber-Vasey technique.
Summary Eleven patients with comminuted fractures of the olecranon have been treated by the Weber-Vasey technique. The operation, complications, and results are discussed.
Outcome of Plate Fixation of Olecranon Fractures
Objectives To evaluate the functional outcome of plate fixation for displaced olecranon fractures, both simple and comminuted. Design Retrospective patient, chart, and radiographic review. Setting Academic teaching hospital. Patients Twenty-five patients who underwent plate fixation of displaced olecranon fractures by two surgeons were independently reviewed at an average follow-up of thirty-four months (range, 15–69 months). Main Outcome Measurements Physical capability was assessed by measuring range of motion and isometric elbow strength. Patient-rated outcomes were evaluated using the SF-36, DASH, Mayo Elbow Performance Index (MEPI), and visual analogue scales for patient satisfaction and pain. Radiographs were evaluated preoperatively, postoperatively, and at the time of final review. Results The average patient age was fifty-four years (range, 14–81 years). The Mayo classification of fractures was fourteen Type II and eleven Type III. An adequate reduction was maintained in all elbows until union. Physical capability measures indicated nonsignificant side-to-side differences in motion or strength, except for supination motion, which was reduced in the injured arm (p = 0.003). The MEPI-rated outcome was twenty-two excellent or good. Patient satisfaction was high (9.7/10), with a low pain rating (1/10). The mean DASH score was consistent with almost normal upper extremity function. The SF-36 showed no difference in physical health as compared with the average American population. Twenty percent of patients required plate removal because of prominence of the internal fixation. The outcome was not influenced by fracture pattern. Conclusion Plate fixation is an effective treatment option for displaced olecranon fractures with a good functional outcome and a low incidence of complications.
Fractures of the head of the radius in children.
1. Full recovery after fracture of the head of the radius in children may be expected in cases with tilting of the radial head from 30 to 60 degrees, whether treated by early manipulative or by operative reduction. 2. Manipulative reduction is facilitated by knowledge of the direction of displacement and tilting of the radial head, which can be determined by the study of appropriate radiographs. 3. When the upper radial epiphysis is completely displaced from the shaft, some permanent loss of movement is to be anticipated even when accurate reduction has been secured by operation. Early fusion and some deformity of the radial head are also to be expected. This is not surprising in view of the risk to the blood supply of the displaced head, particularly in those cases treated by operative reduction.