부산대학교 도서관

Background: Our aim was to determine the effectiveness of a new surgical technique for olecranon fractures using a tension plate (TP) designed by the operating surgeon. Methods: We included patients with olecranon fractures treated between September 2010 and August 2013 in our study. Treatment involved a new implant and operative technique, which combined the most favourable characteristics of 2 frequently used methods, tension band wiring and plate osteosynthesis, while eliminating their shortcomings. The new method was based on the newly constructed implant. Results: Twenty patients participated in our study. We obtained the following functional results with our TP: median flexion 147.5° (interquartile range [IQR] 130°-155°), median extension 135°/deficit 10° (IQR 135°-145°), median pronation 90° (IQR 81.3°-90°), median supination 90° (IQR 80°-90°). Implant-related complications were noted in 1 patient, and implants were removed in 3 patients. The mean functional Mayo elbow performance score was 94.8 (range 65-100). The removal of the implant was considerably less frequent in patients operated using the new method and implant than in patients operated using conventional methods at our institution (p < 0.001). Mean duration of follow-up was 8 months. Conclusion: Our TP for the treatment of olecranon fractures is safe and effective. Functional results are very good, with significantly decreased postoperative inconveniences and need to remove the implant. Less osteosynthetic material was used for TP construction, but stability was preserved. Contexte : Notre but etait de determiner l'efficacite d'une nouvelle technique chirurgicale de reduction des fractures de l'olecrane a l'aide d'un systeme a plaque et broches (SPE), concue par le chirurgien pratiquant l'intervention. Methodes : Nous avons inclus dans notre etude des patients victimes d'une fracture de l'olecrane traites entre septembre 2010 et aout 2013. Le traitement reposait sur un implant et une technique chirurgicale d'un genre nouveau, reunissant les caracteristiques les plus utiles de 2 methodes d'osteosynthese couramment employees, soit le brochage-haubanage et la pose de plaque, tout en permettant d'en eviter les inconvenients. La nouvelle methode a recours a un implant de conception nouvelle. Resultats : Vingt patients ont participe a notre etude. Nous avons obtenu les resultats fonctionnels suivants avec notre SPE : flexion mediane 147,5° (ecart interquartile [EIQ] 130°-155°), extension mediane 135°/deficit 10° (EIq 135°-145°), pronation mediane 90° (eIq 81,3°-90°), supination mediane 90° (EIQ 80°- 90°). Des complications liees a l'implant ont ete notees chez 1 patient et les implants ont ete retires chez 3 patients. Le score fonctionnel moyen a l'echelle MEPS (Mayo elbow performance score) a ete de 94,8 (entre 65 et 100). Les retraits d'implant ont ete nettement moins frequents chez les patients soumis au nouveau type d'intervention et implant que chez les patients soumis aux methodes d'intervention classiques dans notre etablissement (p < 0,001). Le suivi moyen a ete de 8 mois. Conclusion : Notre SPE pour le traitement des fractures de l'olecrane est securitaire et efficace. Les resultats fonctionnels sont tres bons et s'accompagnent d'un nombre significativement moindre de complications postoperatoires et de retraits d'implants. La construction de cette SPE a necessite moins de materiel d'osteosynthese, mais la stabilite a ete preservee.
Olecranon fractures account for 10% of all fractures of the upper extremities. (1) These fractures occur in cases of direct hit in the elbow region or of a pull of [...]