Olecranon fractures are one of the most commonly seen orthopaedic injuries in the emergency room. Fractures of the Olecranon process of the ulna typically occurs because of road traffic accident, a fall, or assault. The accepted line of management of Olecranon fractures depends on the degree of displacement of fragments. In non-displaced fractures, treatment is short period of immobilization followed by gradually increasing range of motion exercises. When displaced, being an intra-articular fracture, surgical management with various modalities of fixation is indicated for good functional outcomes.
Aims and objective: The present study is undertaken to evaluate the results of surgical management of these fractures, the merits and demerits of each fixation method and to assess elbow joint stability and mobility after the procedure.
Materials and Methods: It is a prospective, observational study which was carried out in the Department of Orthopaedics, Government General Hospital, attached to Guntur Medical College, Guntur, Andhra Pradesh, during the period January 2013 to December 2015.During this period, 25 cases of fracture olecranon which were treated by Tension band wiring with Kirschner wires (in Simple transverse fractures) and Olecranon hook plate (for Comminuted fractures), were subjected to clinical observation and the results analyzed. Functional outcomes were estimated using Mayo Elbow Performance score (MEPS).Follow up period of cases is for 2 years.
Results: In our series, majority of the patients were males, in middle age group, with road traffic accident being the commonest mode of injury. Most of the cases were Type II B fractures i.e., oblique and transverse fractures according to Colton’s classification. Surgery was performed within an average period of 4 days (range from 1 to 8 days). Union was noted both clinically and radiologically and functional evaluation was done by Mayo Elbow Performance Score. Excellent results were found in 18 patients (72%), good in 4(16%), fair in 3(12%) and no poor results seen.
Conclusion: From the present study it is concluded that the technique of open reduction and internal fixation with Kirschner wires and figure of eight Tension band wire (for simple transverse and oblique fractures) is a gold standard technique. In comminuted fractures, TBW cannot provide a sufficient buttress for impacted articular fragments. Hence plate fixation which is based on good biomechanical principles is the method of choice and gives reliable results