Early Clinical Outcomes of Polyaxial Locking Cap Plate Fixation for Fixation of Displaced Olecranon Fractures

Document Type : RESEARCH PAPER

Authors

1 Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA

2 Brown University, East Providence, Rhode Island, USA

3 Clinical Orthopaedic Surgery, Shoulder & Elbow Division, University of Pennsylvania, Philadelphia, Pennsylvania, USA

10.22038/abjs.2024.67514.3204

Abstract

Objectives: The purpose of this study is to evaluate the outcomes of a polyaxial locking plate utilizing locking-cap fixation for treatment of patients with displaced olecranon fractures.
Methods: A retrospective review was performed for all consecutive patients at two institutions with displaced olecranon fractures treated with a polyaxial locking plate. Patients were required to have at least 1-year follow up. Clinical outcomes including the Disabilities of the Arm, Shoulder, and Hand (DASH) score, Single Assessment Numeric Evaluation (SANE), along with a Likert-scaled satisfaction survey ranging between 1-5 (1= very unsatisfied and 5= very satisfied) were collected.
Results: The plate osteosynthesis was performed on 24 patients with displaced olecranon fractures. Functional outcome scores were collected on 19 (79.2%) patients. The mean age at the time of surgery was 57.9 years (range, 23 to 78) and mean clinical follow-up was 21.0 ± 6.6 months (range, 12-34 months). All patients achieved osseous union in an acceptable position. Four (16.7%) patients complained of plate related pain and 6 (25%) patients complained of postoperative stiffness. Complications were found in 3 (12.5 %) patients, which included two neuropathies and one hardware failure in which a patient presented following a fall with a broken screw. No patients required revision surgery nor removal of hardware. A total of 16 (84%) patients were somewhat to very satisfied. The mean SANE score was 87.8 ± 14.6 (range: 45-100) and the mean DASH score was 13.8 + 17.5 (range: 0-55.8). Seventeen (89%) patients rated their elbows as 75% or better on SANE assessment and 16 (84%) patients achieved DASH scores of less than 30.
Conclusion: Polyaxial plate fixation utilizing locking-cap technology resulted in excellent short-term functional outcomes in patients with displaced olecranon fractures. Further follow-up is needed to determine the long-term outcomes of locking-cap constructs for olecranon fractures.
        Level of evidence: IV

Keywords

Main Subjects

References

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The Archives of Bone and Joint Surgery
Volume 13, Issue 1
January 2025
Pages 23-29

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History

  • Receive Date: 07 October 2022
  • Revise Date: 06 February 2024
  • Accept Date: 06 February 2024

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