Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation

Abstract

Purpose: Several types of surgical methods from tension band wiring to plate fixation are used in olecranon fractures. In comminuted olecranon fractures, plate fixation is recommended as it is difficult to obtain stable fixation of the bone fragments and joint congruency. The authors performed operations using compression locking plate for olecranon fractures corresponding to Mayo classification IIB and IIIB, and report the radiologic and functional results. Methods: Twenty-one patients who underwent plate fixation surgery for comminuted olecranon fractures at our hospital from September 2011 to April 2019 were enrolled in this study. Patients were retrospectively analyzed for at least 1 year. The classification of olecranon fracture was performed using the Mayo classification. For the analysis of the postoperative results, radiological union time, postoperative range of motion, complications, and functional results based on Mayo elbow performance score (MEPS) were evaluated. Results: The union was achieved in all cases and three posttraumatic arthritis were observed at the final follow-up. The average range of motion was 134.3° in flexion, -9.8° in extension. The mean MEPS was 93.1. There was no statistically significant difference in MEPS between the group that used technique of interfragmentary fixation and the group that did not (p=0.534). Conclusion: Surgical treatment using a locking compression plate fixation in comminuted olecranon fracture resulted in excellent functional results. Restoration of articular surface using Kirschner wire or interfragmentary screw between small bone fragments is considered a useful method for obtaining good functional results.