Excellent results and low complication rate for anatomic polyaxial locking plates in comminuted proximal ulna fractures

J Shoulder Elbow Surg. 2018 Dec;27(12):2198-2206. doi: 10.1016/j.jse.2018.05.032. Epub 2018 Jul 10.

Abstract

Background: Comminuted fractures of the proximal ulna remain a great challenge in orthopedic surgery. The purpose of this study was to report the outcomes of comminuted proximal ulna fractures treated with a new construct type-anatomically preformed polyaxial locking compression plates.

Methods: Between 2013 and 2016, 46 patients with isolated comminuted fractures were treated with a 2.7-/3.5-mm VA-LCP Olecranon Plate (Synthes, Umkirch, Germany). Of these, 44 were available for an assessment after a mean follow-up period of 2.5 years (range, 12-50 months). We evaluated range of motion, time to recovery, revision rate, and indications, as well as functional scores. Radiographs were analyzed.

Results: The study included 8 Mayo IB, 29 Mayo IIB, and 7 Mayo IIIB fractures. All fractures showed bony union, and only 2 revision surgical procedures were performed because of a new trauma. No other complications occurred. Mean range of motion was 139° (range, 105°-150°), and the mean pain level was less than 1 on a visual analog scale. Regarding elbow function, we found a mean Mayo Elbow Performance Score of 98; a mean Oxford Elbow Score of 44; and a mean Disabilities of the Arm, Shoulder and Hand score of 6. Of the plates, 41% were removed after an average time of 16 months, whereby a significant improvement in extension deficit was detected (P < .01). Ninety-five percent of all patients returned to their pretrauma sports level.

Conclusion: The 2.7-/3.5-mm VA-LCP Olecranon Plate represents an effective option with excellent fracture reduction, sufficient stability for early postoperative functional rehabilitation, and a minimum of complications.

Keywords: Olecranon fracture; comminuted; complications; hardware removal; locking compression plate; outcome; polyaxial.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bone Plates*
  • Device Removal / statistics & numerical data
  • Disability Evaluation
  • Female
  • Follow-Up Studies
  • Fracture Fixation, Internal / instrumentation*
  • Fracture Healing
  • Fractures, Comminuted / classification
  • Fractures, Comminuted / surgery*
  • Humans
  • Male
  • Middle Aged
  • Range of Motion, Articular
  • Retrospective Studies
  • Ulna Fractures / surgery*