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Case Report: J-Shaped External Fixator for Treatment of Mayo Type II Olecranon Fractures - A Novel Surgical Technique and Report of Clinical Applications. | LitMetric

AI Article Synopsis

Article Abstract

Purpose: We designed a J-shaped external fixator (J-EF) to provide a minimally invasive, one-step surgical method for olecranon fractures. The aim of this study is to retrospectively review the method and the outcomes in 14 patients treated with J-EF fixation.

Methods: Biomechanical comparative study was performed to test the tensile properties of the J-EF using a universal testing machine. Between January 2002 and December 2005, 14 patients (age range: 25-67 years) with Mayo type II olecranon fractures were treated using the external fixation technique. Follow-up was done by standard measures (radiography, range of motion, and complications monitoring) and patient-reported outcomes (Mayo Elbow Performance Score [MEPS] and Disabilities of the Arm, Shoulder, and Hand [DASH] scores) 6 months after surgery. Eight of the patients were reviewed 15 years after the surgery.

Results: Results from biomechanical studies indicate the non-inferiority of J-EF to tension-band wiring (TBW) in tensile properties. At the time of release, the mean elbow flexion arc was 132.5° and the mean forearm rotation arc was 173.6°. The mean DASH score was 14.1 points, and the mean MEPS was 93.9 points. Operative time and intraoperative blood loss were decreased by 41.3% and 64.6%, respectively, in J-EF patients than those in a comparable group treated by TBW. All eight patients are still alive after the surgery and maintaining the original outcome.

Conclusions: External fixation using the J-EF could be considered as an alternative treatment for Mayo type II olecranon fractures as it appears to be a reliable, minimally invasive, and time-saving.

Level Of Evidence: Therapeutic Level IV.

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Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9240390PMC
http://dx.doi.org/10.3389/fsurg.2022.855600DOI Listing

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Background: Most olecranon fractures are intra-articular, affecting the extensor mechanism of the elbow, and are treated surgically with dorsal plate fixation or tension band. Due to shortcomings of dorsal plates related to prominence, insufficient fixation of sagittal fracture lines, and difficulty matching proximal ulna dorsal angulation (PUDA), dual medial and lateral plating (DP) has been developed. We hypothesized that olecranon fractures treated with DP would have low complication rates and low incidence of hardware removal compared with those treated with traditional methods of fixation.

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Purpose: To explore the clinical efficacy of perforated Kirschner wire tension band in the treatment of Mayo IIA olecranon fracture.

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Background: The authors present a cadaveric validation of a minimally invasive articular cartilage preserving olecranon osteotomy technique for use in the operative management of distal humeral fractures.

Methods: Twenty-four elbows in six male and six female formaldehyde embalmed cadavers were dissected. With the cadaver placed in a lateral decubitus position, a posterior sub-periosteal dissection was performed to the medial and lateral aspects of the olecranon at the level of the joint and Mini Hohmann retractors were inserted into each side of the ulnohumeral joint.

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Ulnar Nerve Management in Complex Elbow Dislocations: A Retrospective Monocentric Study.

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Introduction: Olecranon fractures, particularly the Mayo Type 2A two-part fracture, are typically treated with Kirschner wires (K-wires) and tension band wiring. While effective, this method is associated with a high complication risk, leading to reoperations. Recently, new suture fixation techniques have been described that do not involve the insertion of metal.

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