The Archives of Bone and Joint Surgery

The Archives of Bone and Joint Surgery

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

Document Type : RESEARCH PAPER

Authors
Michael Jason Gutman 1
Manan Sunil Patel 1
James William Connelly 2
Edward Scott Paxton 2
Surena Namdari 1
John Gabriel Horneff 3
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
Clinical outcomes
Elbow fractures
Elbow surgery
Locking cap
Locking plate
Mayo classification
Olecranon fracture
Polyaxial
Subjects
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The Archives of Bone and Joint Surgery
Volume 13, Issue 1
January 2025
Pages 23-29

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