Journal of Musculoskeletal Trauma

Comparison of outcomes of reinforced tension band wiring and precontoured plate and screw fixation in the management of Mayo type IIIB olecranon fractures: Hyun Goo Kang, Tong Joo Lee, Samuel Jaeyoon Won; J Musculoskelet Trauma 2025;38(2):96-101. Published online February 28, 2025; DOI: https://doi.org/10.12671/jmt.2025.00059

Abstract PDF: Background
Mayo type IIIB olecranon fractures are characterized by significant displacement and comminution, presenting a challenge in selecting the appropriate fixation technique. This study compared the clinical and radiographic outcomes, complications, and reoperation rates of reinforced tension band wiring (TBW) and precontoured plate and screw fixation (PF) in the surgical treatment of Mayo type IIIB olecranon fractures.
Methods
This retrospective review analyzed 24 patients diagnosed with Mayo type IIIB olecranon fractures, who were treated between 2005 and 2023. Of these, 11 patients underwent reinforced TBW, and 13 received precontoured PF. Clinical outcomes were assessed using Disabilities of the Arm, Shoulder, and Hand (DASH) scores and the Mayo Elbow Performance Score (MEPS). Radiographic outcomes focused on fracture union. Operative times, complication rates, and reoperation rates were compared between the groups.
Results
Both the reinforced TBW and PF groups achieved satisfactory clinical outcomes, with no significant between-group differences in DASH and MEPS scores (P>0.05). Radiographic union was achieved in all patients. The reinforced TBW group demonstrated a significantly shorter operative time than the PF group (93.6±7.4 min vs. 132.3±13.7 min; P<0.001). Complication rates were similar between the two groups (reinforced TBW, 38.4%; PF, 36.3%), but hardware-related irritation occurred more frequently in the reinforced TBW group. Reoperations were required in 15.8% of the reinforced TBW group due to hardware irritation, whereas no reoperations were necessary in the PF group.
Conclusions
Reinforced TBW and PF are both effective surgical options for managing Mayo type IIIB olecranon fractures, yielding comparable clinical and radiographic outcomes. While reinforced TBW offers shorter operative times and lower costs, PF is associated with fewer hardware-related complications. Further prospective studies are needed to optimize treatment strategies for these complex fractures. Level of Evidence: Level III.

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Is It Essential to Apply Tension Band Wire Fixation in Non-Comminuted Displaced Transverse Fractures of the Olecranon (Mayo Type 2A)?: In-Tae Hong, Cheungsoo Ha, Seongmin Jo, Wooyeol Ahn, Soo-Hong Han; J Korean Fract Soc 2022;35(3):97-102. Published online July 31, 2022; DOI: https://doi.org/10.12671/jkfs.2022.35.3.97

Abstract PDF: Purpose
Various problems have been reported with tension-band wire (TBW) fixation. With the devel-opment of anatomical plates and the improvement of fixation forces, plate fixation is currently being performed for non-comminuted, displaced, transverse olecranon fractures (Mayo Type 2A). This study compared the usefulness of the above two procedures applied in non-comminuted, displaced, transverse olecranon fractures.
Materials and Methods
Fifty-three patients with Mayo Type 2A were studied retrospectively. Twenty-nine patients underwent TBW fixation, while the other 24 underwent plate fixation. The averageoutpatient follow-up period was 10 months for both groups. Both groups were analyzed radiologically and clinically. The radiological assessment included the time to bone union, joint stability, and presence of traumatic osteoarthritis at the final follow-up. The clinical assessment included the operation time,range of motion of the elbow joint, Mayo Elbow Performance Score (MEPS), Disability of the Arm, Shoulder and Hand (DASH) score, and the presence of postoperative complications.
Results
Both groups showed stable elbow joints, proper union of fractures, and no traumatic osteo-arthritis at the final follow-up. The range of motion for the TBW fixation group was 142° (range, 3°-145°), while that of the plate fixation group was 135° (range, 4°-139°) at the final follow-up (p=0.219). The MEPS was 98.2 and 97.7 for the TBW fixation and plate fixation groups, respectively (p=0.675). The DASH score was 10.7 and 13.9 for the TBW fixation and plate fixation groups, respectively. Both groups showed excellent results, and the differences were not statistically significant (p=0.289).
Conclusion
TBW fixation and plate fixation were compared in non-comminuted, displaced, transverse olecranon fractures, and good results were obtained without significant differences between the two groups. Hence, surgeons should choose a technique they are more confident with and can be applied more efficiently.

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Surgical Outcomes of the Monteggia Type 2 Fracture Dislocation in Adults: Sung Choi, Daegeun Jeong, Youngsoo Byun, Taehoe Gu, Sungsoo Ha, Dongju Shin; J Korean Fract Soc 2019;32(1):6-13. Published online January 31, 2019; DOI: https://doi.org/10.12671/jkfs.2019.32.1.6

Abstract PDF: PURPOSE
This study examined clinical outcomes of Monteggia fracture type 2, which is the most common in adults with a high rate of accompanied injuries.
MATERIALS AND METHODS
From June 2004 to November 2015, a retrospective study was performed on 12 patients diagnosed with Monteggia fracture type 2 with a follow-up period of at least 6 months after surgery. The clinical outcomes were evaluated using the Mayo elbow performance score (MEPS), and the existence of accompanied injures, radiological result, and complications were analyzed.
RESULTS
Posterior instability was confirmed in all patients and accompanied fractures were detected in 9 patients (75.0%) on the radial head, whereas 10 patients (83.3%) were found on the coronoid process. The average arc of motion was 107Â° (70Â°â€“130Â°) and the mean MEPS was 89 (45â€“100). Additional re-operation due to re-dislocation, radioulnar synostosis, elbow instability, ulna nonunion, and radial head nonunion were performed in 4 cases (33.3%).
CONCLUSION
The Monteggia fracture type 2 is more commonly associated with radial head fractures and coronoid process fractures rather than other types, which causes elbow instability. Because the rate of additional surgery due to complications is high, the treatment of Monteggia fracture type 2 requires careful assessments.

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Cannulated Screw and Wire Fixation with Predrilling for Olecranon Osteotomy in Intra-articular Comminuted Distal Humerus Fractures: Soo Hong Han, Ho Jae Lee, Woo Hyun Kim, Yong Gil Jo, Won Tae Song; J Korean Fract Soc 2015;28(2):118-124. Published online April 30, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.2.118

Abstract PDF: PURPOSE
The olecranon osteotomy in intra-articular comminuted distal humerus fractures is a suggested technique for excellent exposure of articular fractures. However, complications including delayed union, nonunion of osteotomy site have been reported. Authors have applied predrilling for cannulated screw before osteotomy for achievement of rapid and accurate reposition of separation part and added wire fixation for secure stability. The purpose of this study is to evaluate the efficacy of this fixation procedure following the olecranon osteotomy during the internal fixation of intra-articular fracture of the distal humerus.
MATERIALS AND METHODS
This study retrospectively analyzed 14 cases (9 women and 5 men) of intra-articular distal humerus fractures in which the olecranon osteotomy was applied. The mean age of patients was 53.4 years (range, 25 to 83 years), and the average follow-up period was 15.9 months. Eleven cases were classified as AO 13-C3, and the other 3 cases were AO 13-C2. Reduction accuracy, union period of osteotomy site on follow-up radiographs and postoperative complications related to olecranon osteotomy were evaluated.
RESULTS
All osteotomized parts showed no position change and solid union with normal alignment at the last follow-up. The mean period of bony union was 3.5 months (range, 2 to 5 months). There were no complications related to olecranon osteotomy except one case of non-displaced fracture of the proximal ulnar shaft at the level of cannulated screw tip caused by forceful passive physical therapy. It was managed by conservative treatment without further problem.
CONCLUSION
Predrilled cannulated screw and wire fixation following the olecranon osteotomy during internal fixation of intra-articular comminuted distal humerus fractures showed satisfactory results in the union of osteotomy site and it could be a recommendable procedure when fractures require olecranon osteotomy.

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Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates: Ki Do Hong, Tae Ho Kim, Jae Cheon Sim, Sung Sik Ha, Min Chul Sung, Jong Hyun Jeon; J Korean Fract Soc 2015;28(1):59-64. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.59

Abstract PDF: PURPOSE
The purpose of this study is to evaluate the clinical results of locking compression plate (LCP) fixation for olecranon fractures with proximal ulna comminution.
MATERIALS AND METHODS
We review 10 cases of olecranon fractures with proximal ulna comminution treated with LCPs from August 2011 to August 2013. Follow-up period was from 12 months to 18 months. Mean age was 63.1 years (35-84 years). According to the Mayo classification, there were eight type IIB, and two type IIIB fractures. We used Mayo classification. Clinical evaluation was performed based on radiographic union of olecranon and measurements of range of motion at last follow-up. Disability of the arm, shoulder and hand (DASH) score and Mayo elbow performance score (MEPS) were used for evaluation of functional recovery.
RESULTS
All patients had bone union. According to the MEPS, nine of ten patients had a good or excellent outcome. The mean DASH score was 18.6. All cases started postoperative range of motion (ROM) within 14 days. Elbow ROM was more than 110degrees in all cases except one. Mean radiological bony union time was 4.2 months (2.5-6.0 months) postoperatively. Complication was hardware irritation in three patients.
CONCLUSION
Internal fixation using LCP for olecranon fractures with proximal ulna comminution can be a good treatment option which obtains good clinical results and enables early ROM.

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Olecranon Nonunion after Operative Treatment of Fracture: Ho Jung Kang, Ji Sup Kim, Myung Ho Shin, Il Hyun Koh, Yun Rak Choi; J Korean Fract Soc 2015;28(1):30-37. Published online January 31, 2015; DOI: https://doi.org/10.12671/jkfs.2015.28.1.30

Abstract PDF: PURPOSE
Olecranon nonunion after surgical management is relatively rare, but it leads to limitation of motion of joint or instability. This retrospective study was conducted in order to analyze the cause and result of treatment.
MATERIALS AND METHODS
We analyzed 11 cases treated for nonunion of olecranon fractures. Nonunion was classified according to the spot of the lesion and the extent of articular surface damage. Evaluation was performed using Mayo elbow performance score (MEPS), Oxford elbow score (OES), Disabilities of the Arm, Shoulder and Hand (DASH) scores, and the range of motion.
RESULTS
According to the spot of the lesion and the extent of articular surface damage, nonunion was categorized as IA (2 cases), IIA (5 cases), and IIIA (4 cases). One case of IA underwent nonunion fragment excision and the remaining cases were treated by bone grafting. A plate was used in seven cases and the other three cases had both plate and tension band wiring fixation. All nonunions finally became union. The 11 patients with one year follow-up had average MEPS of 87.7 points (range: 60-100 points), average OES of 43.2, and average DASH score of 18.8 points. Complications included limitation of motion (2 cases) and ulnar nerve symptoms (3 cases).
CONCLUSION
Bone grafting and fixation by plate may be beneficial. In addition, excision can be useful in type I.

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Surgical Treatment Using a Transolecranon Approach with a Dual Locking Plate for Unstable Intercondylar Fractures of the Humerus: Ji Kang Park, Yong Min Kim, Dong Soo Kim, Eui Sung Choi, Hyun Chul Shon, Kyoung Jin Park, Byung Ki Cho; J Korean Fract Soc 2012;25(2):129-135. Published online April 30, 2012; DOI: https://doi.org/10.12671/jkfs.2012.25.2.129

Abstract PDF: PURPOSE
To evaluate the clinical outcomes of operative treatment using a transolecranon approach with a dual locking plate for unstable intercondylar fractures of the distal humerus.
MATERIALS AND METHODS
Eighteen patients were followed for more than 1 year after surgical treatment for unstable intercondylar fractures of the humerus. Anterior transpositioning of the ulnar nerve and an early rehabilitation program to allow range of motion (ROM) exercise from postoperative week 1 were used for all cases. The clinical and functional evaluation was performed according to the Mayo Elbow Performance Index and Cassebaum's classification of ROM.
RESULTS
The range of elbow joint motion was a flexion contracture mean of 12.8 degrees to a further flexion mean of 119.3 degrees at the final follow-up. The Mayo Elbow Performance Index was an average of 88.5 points. Among the results, 6 were excellent, 9 good, 2 fair, and 1 poor. Therefore, 15 cases (83.3%) achieved satisfactory results. Fourteen cases (77.7%) achieved a satisfactory ROM according to Cassebaum's classification. All cases achieved bone union, and the interval to union was an average of 14.2 weeks.
CONCLUSION
Dual locking plate fixation through the transolecranon approach seems to be one of the effective treatment methods for unstable intercondylar fractures of the humerus because it enables the anatomical reduction and rigid fixation of articulation, and early rehabilitation exercise.

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Operative Treatment of Distal Humeral Comminuted Fractures with Orthogonal Plating: Joong Bae Seo, Jae Sung Yoo; J Korean Fract Soc 2011;24(3):243-248. Published online July 31, 2011; DOI: https://doi.org/10.12671/jkfs.2011.24.3.243

Abstract PDF: PURPOSE
To analyze the results of operative treatment for Comminuted Fracture of Distal Humerus with Transolecranon approach and Orthogonal plating.
MATERIALS AND METHODS
The subjects were 22 patients with Comminuted fracture of humerus who were treated with Orthogonal plating. Patient's age, sex, type of fracture, surgical approach, method of fixation, time of operation, time of bony union, complication, range of motion were investigated, and Function of elbow was evaluated by functional evaluation of Riseborough and Radin, Mayo Elbow Performance Score (MEPS).
RESULTS
Age, sex, injuried arm, operation time were not related to postoperative result. Type C2 fractures showed better results in function and range of motion (ROM) than type C3 fractures. Also early rehabilitation was important to functional recovery and ROM. The postoperative ROM was average 110. Good were 16 cases, fair were 6 cases in functional evaluation of Riseborough and Radin. Excellent were 13 cases, good were 8 cases, fair was 1 case in MEPS.
CONCLUSION
Operative treatment with Transolecranon approach and Orthogonal plating showed favorable result on its function. Intraarticular comminution and early rehabilitation were closely related to postoperative function of elbow.

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Treatment of Ulnar Olecranon Fracture Using Acutrak Screw: Hyungchun Kim, Kwangryul Kim, Moonsup Lim, Youngil Park, Inhwan Hwang, Jihoon Lee; J Korean Fract Soc 2009;22(4):270-275. Published online October 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.4.270

Abstract PDF: PURPOSE
To evaluate the clinical results of Acutrak screw fixation for ulnar olecranon fractures. MATERIALS AND METHODS: We reviewed 15 cases of ulnar olecranon fractures which were treated with Acutrak screws from February 2003 to September 2007. Follow-up period is from 12 months to 42 months. We used Mayo classification. Radiologic results were analyzed according to step-off, gap, reduction loss, and functional results were analyzed according to pain and ROM. We analyzed union time, operation time, incision size and complications. RESULTS: In functional results, there were 3 good cases out of 3 Mayo type IA, 8 good cases and 2 fair cases out of 10 type IIA, 1 fair case and 1 poor case out of 2 type IIB. In radiologic results, there was 1 case of reduction loss. Average union time was 9.4 weeks, average operation time was 24 minutes and average incision size was 1.8 cm. CONCLUSION: We conclude that Acutrak screw fixation can be a treatment option for olecranon fracture of Mayo type IA and IIA.

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Internal Fixation Using Double Plates for Comminuted Olecranon Fractures in Adults: Hyun Dae Shin, Jae Hoon Yang, Pil Sung Kim; J Korean Fract Soc 2009;22(3):166-171. Published online July 31, 2009; DOI: https://doi.org/10.12671/jkfs.2009.22.3.166

Abstract PDF

PURPOSE
To evaluate the clinical usefulness of internal fixation with double plates for comminuted olecranon fractures.
MATERIALS AND METHODS
Nine patients with olecranon fractures which are classified into Mayo type IIB (7 cases) and type IIIB (2 cases) underwent internal fixation using double plates from June 2002 to September 2005. They were followed-up for more than 12 months and average period of follow-up was 14 (12~18) months. Six cases were males and three were females. Mean age was 40.7 (21~63) years. We used open reduction and internal fixation using double plates. Clinical assessment index was pain, range of motion (ROM), stability and function of joint at last follow-up. The sum of four indices were compared. Also, we evaluated starting time of full ROM exercise, bony union time and complications.
RESULTS
All cases started postoperative ROM within 7 days and clinical results were evaluated using Mayo elbow performance index. 'Excellent', 'good' were 2, 6 cases, respectively and 1 case was 'fair'. Elbow ROM was more than 110o in all cases except one. Mean radiological bony union time was 3.9 (2.5~5) months postoperatively. There were heterotrophic ossifications in 3 cases as complication.
CONCLUSION
Internal fixation using double plates for comminuted olecranon fractures in adults can be good treatment option which obtains good clinical results and enables early ROM.

Citations

Citations to this article as recorded by

Biomechanical Comparison of Dual and Posterior Locking Plates in an Ex Vivo Comminuted Olecranon Fracture Model
Andrew D. Sobel, Jacob M. Babu, Travis D. Blood, E. Scott Paxton
The Journal of Hand Surgery.2022; 47(8): 796.e1. CrossRef
Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation
Eunchang Lee, Seong-Hee Cho, Jun-Il Yoo, Jin-Hyung Im, Dong-Geun Kang, Jin Sung Park
Archives of Hand and Microsurgery.2021; 26(1): 18. CrossRef
The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture
In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han
Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures
Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon
Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef

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Double Tension Band Wiring for Olecranon Fractures: Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim; J Korean Fract Soc 2008;21(2):130-134. Published online April 30, 2008; DOI: https://doi.org/10.12671/jkfs.2008.21.2.130

Abstract PDF

PURPOSE
To evaluate the clinical results of double tension band wiring for communited olecranon fractures involving proximal 1/3.
MATERIALS AND METHODS
We reviewed 9 cases of communited olecranon fractures involving proximal 1/3 treated with double tension band wiring followed for minimum 10 months. There were 2 cases of olecranon fractures involving only proximal 1/3, 6 cases of olecranon fractures involving from proximal 1/3 to middle 1/3 and 1 case of olecranon fractures involving from proximal 1/3 to distal 1/3. We analyzed the bone union time, radiologic results for gap, reduction loss, pin migration, pain, range of motion, complications and functional outcomes at last follow up.
RESULTS
All patients had solid bone union without additional surgery and average union time was 10.3 weeks. Anatomical reduction could be obtained in 8 of 9 cases but there was 1 mm step off in one case. 36 pins were used to fix the fractures, 1 pin of 18 distal pins and 2 pins of 18 proximal pins were migrated to backward but there was no reduction loss. Only 1 distal pin needed early removal due to skin irritation. Average range of motion ranged from flexion contracture 3.3 degrees to further flexion 137.8 degrees. On functional analysis, we got 8 cases of good result, 1 case of fair result and there was no poor result.
CONCLUSION
Double tension band wiring for comminuted olecranon fracture involving proximal 1/3 was concluded to give a firm fixation of the fracture site as bone union could be acquired without serious pin problems.

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Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
Olecranon Nonunion after Operative Treatment of Fracture
Ho-Jung Kang, Ji-Sup Kim, Myung-Ho Shin, Il-Hyun Koh, Yun-Rak Choi
Journal of the Korean Fracture Society.2015; 28(1): 30. CrossRef

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Operative Treatment of Displaced Intercondylar Fracture of the Distal Humerus with Reconstruction Plate: Ryuh Sup Kim, Tong Joo Lee, Kyoung Ho Moon, Seung Rim Park, Moon Lee; J Korean Fract Soc 2007;20(2):172-177. Published online April 30, 2007; DOI: https://doi.org/10.12671/jkfs.2007.20.2.172

Abstract PDF: PURPOSE
To evaluate the therapeutic effects of chevron olecranon osteotomy and bilateral reconstruction plate as operative treatment for distal humerus intercondylar fracture.
MATERIALS AND METHODS
Among patients operated for distal humerus intercondylar fracture in our hospital from June, 1997 to October, 2005, 26 patients were selected who could be followed-up for more than one year. The average follow-up period was 15 months. All olecranon osteotomies were chevron osteotomy and all fractures were treated with internal fixation using bilateral reconstruction plate. The ulnar nerve was checked in all cases. Three patients in which case the plate might irritate the ulnar nerve, received with ulnar nerve anterior transposition. Cassebaum's classification and Mayo elbow performance score were used to evaluate at three, six and twelve months.
RESULTS
Mean bone union period was 11.7 weeks. There were 9 excellent cases, 11 good cases, 4 fair cases and 2 poor cases. Mean flexion contracture was 11Â° and further flexion was 126Â° at last follow-up.
CONCLUSION
Bilateral reconstruction plate internal fixation using chevron olecranon osteotomy showed strong fixation and good clinical results and it is possible for early rehabilitation treatment.

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Clinical Outcome of Surgical Treatment of Distal Humerus Intercondylar Fractures Through the Transolecranon Approach Combined with Anterior Transposition of the Ulnar Nerve: Kwang Hyun Lee, Seong Pil Lee, Kyu Tae Hwang, Joo Hak Kim; J Korean Fract Soc 2004;17(2):70-75. Published online April 30, 2004; DOI: https://doi.org/10.12671/jkfs.2004.17.2.70

Abstract PDF: PURPOSE
To analyze the clinical outcomes of surgical treatment of distal humerus intercondylar fractures through the transolecranon approach combined with anterior transposition of the ulnar nerve.
MATERIALS AND METHODS
Eight patients who had distal humerus intercondylar fractures were included in this study and underwent operative treatment through the transolecranon approach for sufficient operative field with anterior transposition of the ulnar nerve and fixed with reconstruction plate.
RESULTS
The results were evaluated using Riseborough and Radin rating criteria. Seven cases of eight cases were achieved good results with flexion contracture less than 30 degrees and forward flexion more than 115 degrees. However, one case was acheived poor result with 40 degrees of flexion contractue and 70 degrees of forward flexion. There were no the compressive ulnar neuropathy.
CONCLUSION
We found the transolecranon approach and anterior transposition of the ulnar nerve a viable option for surgical treatment of the distal humerus intercondylar fractures

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Reconstruction of the coronoid process using a graft from the olecranon of the same side for chronic posterior dislocation of the elbow: Jin Ho Kim, Seung Taek Song, Young Jin Sohn; J Korean Soc Fract 2002;15(3):410-413. Published online July 31, 2002; DOI: https://doi.org/10.12671/jksf.2002.15.3.410

Abstract PDF: It is reported when posterior dislocation of the elbow with the fracture of the coronoid process is occurred, if they can 't achieve the reduction of coronoid process, the patient would have the elbow instability. That is required to open reduction of coronoid process. Limitation of the elbow motion and persistent posterior dislocation of the elbow result from failure of reduction of coronoid process in acute injury. That patients have been treated by distraction arthroplasty, total elbow replacement, arthrodesis, and coronoid process reconstruction. We experienced one case that had a excellent result from reconstruction of the coronoid process using a graft from the olecranon of same side in 28 years old man.

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Treatment of Transolecranon Fracture-Dislocation of the Elbow: Soo Yong Kang, Han Jun Lee, Jung Nam Han, Kyoung Hwan Kim; J Korean Soc Fract 2001;14(1):99-105. Published online January 31, 2001; DOI: https://doi.org/10.12671/jksf.2001.14.1.99

Abstract PDF: PURPOSE
We conducted this study to discriminate transolecranon fracture-dislocation of the elbow from the anterior Monteggia lesion and to validate the differences of method of treatment.
MATERIALS AND METHOD
From March, 1998 to May, 1999, 3 cases of the transolecranon fracture-dislocation of the elbow were treated by open reduction and internal fixation.One of the three patients had simple oblique fracture of the olecranon combined with capitellum fracture and two had complex comminuted fracture of the olecranon. Functional outcome was assessed with elbow performance rating system of Broberg and Morrey.
RESULTS
At a minimum follow-up of 12 months, overall outcome was rated as exellent in two patients, fair in one. Average bone union peoriod was three months.
CONCLUSION
Stable restoration of the accurate contour and dimension of the trochlear notch of the olecranon and early ROM exercise will lead to good result in transolecranon fracture-dislocation cases.

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Functional Results of Olecranon Fracture-Dislocation According to the Methods of Internal Fixation: Won Sik Choy, Yong Bum Park, Kwang Won Lee, Whoan Jeang Kim, Ha Yong Kim, Jae Hun An, Chang Soo Ryu; J Korean Soc Fract 2000;13(2):414-420. Published online April 30, 2000; DOI: https://doi.org/10.12671/jksf.2000.13.2.414

Abstract PDF: PURPOSE
: This study was performed to compare the functional results according to the methods of internal fixation in olecranon fracture-dislocation.
MATERIALS AND METHODS
: Authors retrospectively analyzed in 13 adult patients with olecranon fracture-dislocation (Colton II D) who were treated by internal fixation from January 1991 to June 1998. Functional results were assessed by Broberg and Morrey system and radiographic results were analyzed in terms of articular step-off, articular gap and reduction loss.
RESULTS
: In regard to functional assessment, all oblique fractures treated with plate and screw showed 100% of satisfactory result whereas those treated with tension bands showed 33.4% of satisfactory result. Comminuted fractures treated with plate and screw showed 40% of satisfactory result whereas all two treated with tesion bands resulted in unsatisfactory result. In regard to radiologic assessment, three oblique fractures treated with plate and screw result whereas those treated with tension bands resulted in fair result. Comminuted fractures treated with plate and screw resulted in three fair, two poor radiologic results whereas those treated with tension bands resulted in one fair, one poor result.
CONCLUSION
: Plate and screw fixation can obtain more satisfactory functional and radiologic results than tension bands in oblique and comminuted olecranon fracture-dislocation

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Treatment of comminuted distal humeral intercondylar fracture using transolecranon approach: Kwang Hyun Lee, Myung Ryul Park, Jae Min Lee, Tae Hyoung Kweon; J Korean Soc Fract 1999;12(4):981-987. Published online October 31, 1999; DOI: https://doi.org/10.12671/jksf.1999.12.4.981

Abstract PDF: Fracture of the distal humerus is rare, so the surgeons experience is limited. This injuries represent a constellation of complex articular fractures and anatomic complexity of distal humerus makes surgical treatment, open reduction and internal fixation is difficult. We analyze the clinical result of immediate open reduction, rigid internal fixation, and early postoperative motion. From Nov. 1990 to Sep. 1997, the authors analyzed the clinical results of 5 cases those who underwent operative treatment using transolecranon approach, internal fixation with Y plate and early motion for comminuted distal humeral intercondylar fracture. ROM exercise was started at average 2.2 weeks postoperatively. 4 of 5 patients obtained satisfactory results by Riseborough and Radin rating criteria. One patient obtained poor result of 40 degree flexion contracture and 90 degree further flexion of elbow. Transolecranon approach makes the complete anatomic reduction of articular surface possible and the satisfactory results is associated with immediate, complete anatomic reduction and rigid fixation in conjuction with early postoperative motion.

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Operative Treatment of Olecranon Fractures Using Tension Band Wiring: Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Joon Uoung Uang, Young Mo Kim, Mun Jong Lee, Jin Soo Kim; J Korean Soc Fract 1998;11(3):672-682. Published online July 31, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.3.672

Abstract PDF

We treated 26 cases(25 patients) olecranon fractures operatively with Kirschner wire and tension band wiring technique from January 1993 to December 1995. The Kirschner wire fixation methods in our study were either bicortical fixation(15 cases) or intramedullary fixation(11 cases). We retrospectively reviewed clinical results according to Mayo elbow performance index and starting time of full range of motion(ROM) exercise. We analyzed relationship between the cli9nical results of the cases with cast immobilization and those without cast immobilization. We also compared Kirschner wire fixation methods in the respect of clinical results, full ROM exercise starting time and complications. The results were as follows. 1. Clinical results were excellent or good in 25 cases(96%) according to Mayo elbow performance index. Full ROM exercise starting time was within 2weeks in 10 cases, between 2-3weeks in 11 cases, between 5-6weeks in four cases and after 6weeks in one case. Full ROM exercise starting time was significantly different(P=0.016) with clinical results statistically and there was statistically high significant difference(P=0.0025) between clinical results and cast immobilization or not. 2. Clinical results of bicortical fixation group was ont significantly different frmo those of intramedullary fixation group and there was no significant difference between full ROM exercise starting time and Kirschner fixation methods statistically. 3. The most frequent complications were decreased ROM and loosening of the Kirschner wire. There were decreased ROM In 10 cases and loosening of the Kirschner wire in 6 cases in all cases. We encountered more higher incidence of complications related to intramedullary fixation method. The clinical results and full ROM exercise starting time of bicortical fixation group were not significantly different with those of intramedullary fixation group statistically. But more early exercise, more better clinical results and more less complications was produced in bicortical fixation group. So we thought bicortical fixation method is better than intramedullary fixation method.

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Double Tension Band Wiring for Olecranon Fractures
Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim
Journal of the Korean Fracture Society.2008; 21(2): 130. CrossRef

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Operative Treatment of the Intercondyle of the Humerus in adults: Hyun Dae Shin, Kwang Jin Rhee, June Kyu Lee, Won Sok Lee, Seung Jin Lee; J Korean Soc Fract 1998;11(2):345-353. Published online April 30, 1998; DOI: https://doi.org/10.12671/jksf.1998.11.2.345

Abstract PDF: We had studied the results of operative treatments in twenty-seven interconylar fractures of the distal end of the humerus over a ten-year period retrospectively. From march 1989 to February 1996, 27 patients were included in this study. The fracture patterns were classified according to the system of Muller et al. and evaluated the results of the involved elbow by Jupiter's scale. The mean follow-up was 47.8 months. The operation method was open reduction by wide exposure and transolecranon approach and internal fixation between two condyles by cancellous screw or Hebert screw and two reconstruction plate rectangularly each other. Among 27, 17 were men and left elbow were 15. The mean average age was 50.2 (23- 72)years old. The most common injury mechanism was direct trauma in 18 cases(62.9%). By Muller classification C3 type were 12 cases(44.4%), while C1 were 5 cases and C2 were 5 cases and C2 were 10 cases. At last follow-up the elow ROM was average flexion angle 107 degrees(18 to 125 degrees). Except intolerable pain and partial stiffness of elbow, the postoperative complications were 4 cases ; dsyesthia of ulnar nerve were 2, infection were 1, and heterotopic ossification was 1 case. The results of excellent and good were 20 cases(74.1%). In 7 cases of fair and poor results, C3 were 4 cases and C2 were 2 cases. It was concluded that the transolecranon approach and dual-plate fixation on humerus for fractures of the intercondyle of the humerus was satisfactory and necessary to effort of rigid fixation and a early rehabilitation after operation as possible.

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Fracture of Olecranon Treated by K-wire and Tension Band Wiring Technique in Adults: Hak Yeong Jeong, Seung Wook Yang, Jae Woong Shim, Beyong Seon Kong; J Korean Soc Fract 1997;10(3):651-657. Published online July 31, 1997; DOI: https://doi.org/10.12671/jksf.1997.10.3.651

Abstract PDF: Displaced fractures of olecranon in adults require operative treatment. The goal of treatment is to rigidly fix the fracture fragment, to anatomically restore the joint surface and to allow range of motioin early. Authors treated fractures of olecranon by open reduction and internal fixation using K-wire and tension band wiring technique in 38 adult patients from April 1989 to October 1995 at the Department of Orthopedic Surgery, Maryknoll Hospital. This article documents the study of relationship between the treatment result and involvement of articular surface, articular step-off and gap of articular surface. The results were as follows ; 1. The clinical results were good or fair in 31 cases(82%) according to the criteria by Helm et al. 2. Involvement of articular surface, step-off and gap of articular surface affected the results. 3. The clinical results were satisfactory in patients with postoperative step-off less than 2mm and postoperative gap of articular surface less than 2mm. 4. The clinical results were satisfactory in patients with articular involvement less than 60%.

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Treatment of Intercondrlar Fracture of Elbow using Y-Plate through Extraartieular Olecranon Osteotomy in the Posterior Approach: Ho Guen Chang, Sang Su Lee, Eung Ju Lee, Jun Dong Chang, Won Ho Cho, Chang Ju Lee; J Korean Soc Fract 1996;9(4):1118-1124. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1118

Abstract PDF: Iniercondylar fractures of the distal humerus in adults are rare and notoriously difficult to treat. We treated 8 patients by open reduction and internal fixation using Y-plate with extraarticular olecranon osteotomy in posterior approach. L-shaped osteotomy was performed at the extraarticular portion of olecranon with triceps tendon insertian remained to proximal portion of it, using air-saw. The follow-up period ranged from 12 to 30 months with average of 19.7 months. The fractures were dassified according to AO classification. The results were evaluated using Jupiter et al grading system. 1) There was no loosening of fixation Cevice of humeral condyle and olecranon. 2) Niether delayed union nor nonunion of olecranon and humeral condyle were found. 3) Exellent grade was achieved in 4 patients(50%), three(38%) had good, and one(12%) poor. Flexion-extension arc ranged from 60 degree to 120 degree with mean of 98.8 degree. 4) Complications included postoperatile neuritis in one, myositis ossificance in one, and heterotopic bone in one patient. Authors would introduce the method and result of extraarticular olecranon osteotomy in posterior approach for the intercondylar fracture of distal humerus, as a new technique.

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Comparison between Transolecranon Approach and Posterior Approach in Comminuted Intercondylar Fracture of the Distal Humerus: Soo Kyoon Rah, Sang Ki Kim, Joong Geun Choi, Yon Il Kim, Chang Uk Choi; J Korean Soc Fract 1996;9(4):1069-1075. Published online October 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.4.1069

Abstract PDF

The comminuted iniercondyiar fractvre of the distal humeruf is rather uncommon injury. Because of anatomic complexity of the distal humerus, any incongrousness makes loss of function of the elbow joint. Hence, for the complete restoration of the articular surface and joint nlotion, wide exposure is necessary, while stable internal fixation and early post operative exercise should be conducted. With the frefuency of comminution and displacement, this intraarticular fracture is difficult to treat. But the fabrication of new implants and development of surgical approach method has increased the reliability of operative stabilization. The authors compared 36 patients of distal humeral fracture treated with transolecranon approach and Campbells posterior approach at the Department of Orthopaedic Surgery. College of Medicine, Soonchunhyang University from Dec. 1991 to Oct. 1994 and following results were obtained. In transolecranon approach, the operation time was slightly longer with technical difficulties. However, we had excellent exposure of posterior aspect of lower end of the humerus and had a good range of motion, especially in flexion contracture compared with posterior approach. Also, we hardly observed complications of fracture of the olecranon in transolecranon approach.

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Clinical Outcome of Surgical Treatment for Intra-articular Distal Humerus Fracture
Myung Jin Lee, Hyeon Jun Kim, Sung Keun Sohn, Kyu Yeol Lee, Sung Soo Kim, Chul Hong Kim, Lib Wang, Hyun Woo Sung
Journal of the Korean Fracture Society.2010; 23(2): 201. CrossRef

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Fractures of the Olecranon of Ulna treated by Plating and Tension-Band Wiring technique: Jun Mo Lee, Jong Hyuk Park; J Korean Soc Fract 1996;9(3):801-808. Published online July 31, 1996; DOI: https://doi.org/10.12671/jksf.1996.9.3.801

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Fractures of the olecranon of ulna are caused by a number of different mechanisms including a direct blow, a fall on the stretched hand with the elbow in flexion leading to an avulsion fracture by the contracture of the triceps, and by higher energy trauma. Olecranon fractures are intraarticular and frequently unable to manage by manipulation, therefore an open reduction and internal fixation procedure is usually indicated. Authors have experienced and compared the results of 21 cases who were treated by plating and tension-band wiring technique from March 1989 through February 1996 at the Department of Orthopedic Surgery, Chonbuk National Liniversity llospital. The results were as follows, 1. fractures treated by plating were type II. C comminuted fractures(6 cases, 28%), type II. D frac ture/dislocations(2 cases,10%) and type II. B transverse and oblique fractures(2 cases, 10%) in Coltons classification. 2. Plating was the preferred technique for the type II. C and II. D fractures which need autogenous iliac cancellous bone grafting and early active rehabilitation. 3. All of 21 cases were followed up for more than 15 months after surgery and showed good and excellent results according to Weseleys criteria. 4. In tension-band wiring, olecranon bursitis was occurred in 1 case.

Citations

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The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture
In-Tae Hong, Kyunghun Jung, Yoon Seok Kim, Soo-Hong Han
Archives of Hand and Microsurgery.2019; 24(2): 133. CrossRef
Treatment of Olecranon Fractures with Proximal Ulna Comminution Using Locking Compression Plates
Ki-Do Hong, Tae-Ho Kim, Jae-Cheon Sim, Sung-Sik Ha, Min-Chul Sung, Jong-Hyun Jeon
Journal of the Korean Fracture Society.2015; 28(1): 59. CrossRef
A Retrospective Comparative Study of Internal Fixation with Contoured Plate Using Bicortical Screw Versus a Double Plate in Comminuted Olecranon Fractures
Bo-Kun Kim, Hyun-Dae Shin, Kyung-Cheon Kim, Yoo-Sun Jeon
Journal of the Korean Orthopaedic Association.2011; 46(2): 146. CrossRef
Internal Fixation Using Double Plates for Comminuted Olecranon Fractures in Adults
Hyun-Dae Shin, Jae-Hoon Yang, Pil-Sung Kim
Journal of the Korean Fracture Society.2009; 22(3): 166. CrossRef

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Clinical Study for Humerus Intercondylar Fracture in Adult: Hyung Ku Yoon, Kuk Rwan Oh, Kyung Hoon Kang, Jin Il Kim, Kye Sung Lee; J Korean Soc Fract 1995;8(1):93-100. Published online January 31, 1995; DOI: https://doi.org/10.12671/jksf.1995.8.1.93

Abstract PDF: The intercondylar fracture of distal humerus in adult is difficult to treat. Because it is difficult to obtain accurate anatomical reduction atd rigid internal fixation due to comminution and intraarticular components. The authors review the 13 cases of intercondylar fracture of the distal humerus in adult that were treated at the orthopaedic department of Sung Ae Hospital, from JAN 1988 to JUN 1992, and the result are as follows: 1. It was frequently occured in 3rd and 4th decades active male and old female over 60 years old. 2. We think that cast hinge elbow brace is recommendable method for improvement of elbow ROM through early active motion. 3. For accurate anatomical reduction and rigid internal fixation, transolecranon approach is recommended for the suffcient exposure of the articular surface.

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Operative Treatment of Olecranon Fracture: Sang Won Park, Chang Yong Hur, Jae Hak Shim; J Korean Soc Fract 1994;7(1):58-64. Published online May 31, 1994; DOI: https://doi.org/10.12671/jksf.1994.7.1.58

Abstract PDF

Most olecranon fractures are intraarticular and therefore can compromise the stability of the elbow joint. When dispaced, open reduction and internal fixation are usually requried to obtain anatomic realignment of the articular surface and restore normal elbow function. In a retrospective study of 27 patients, fractures of the olecranon with operative treatment were analyzed for relationship between the treatment result and type of fracture, treatment method, articular involvement, and postoperative step-off of articular surface from July, 1986 to September 1992 and following results were obtained. 1. There were f type I, 19 type II and 1 type III according to Mayo classification. 2. The methods of treatment were 6 cases(21%) of open reduction and medullary nailing, 16 cases(55%) of open reduction and tension band wiring, 2 cases(7%) of proximal fragment excision, and 3 cases of screw fixation 3. Clinical results were good in 13 cases(48%), 9 fair(35%), 5 poor(17%) according to the criteria by Helm et al. Radiologic results were good in 12 cases(45%), 8 fair(30%), 5 poor(19%) except 2 cases of fragment excision. 4. The most common complication was protrusion of fixation device(14 cases:52%). 5. The poor result was noted mostly in Mayo fracture type III , articular involvement more than 60%, and postoperative step-off more than 2mm.

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Treatment of Ulnar Olecranon Fracture Using Acutrak Screw
Hyungchun Kim, Kwangryul Kim, Moonsup Lim, Youngil Park, Inhwan Hwang, Jihoon Lee
Journal of the Korean Fracture Society.2009; 22(4): 270. CrossRef
Double Tension Band Wiring for Olecranon Fractures
Suk Kang, Chung Soo Hwang, Phil Hyun Chung, Young Sung Kim, Jin Wook Chung, Jong Pil Kim
Journal of the Korean Fracture Society.2008; 21(2): 130. CrossRef

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Surgical treatment of olecranon fracture: Sang Ho Ha, Jae Won You, Dong Min Shin, Young Bae Pyo, Byoung Ho Lee; J Korean Soc Fract 1991;4(2):320-325. Published online November 30, 1991; DOI: https://doi.org/10.12671/jksf.1991.4.2.320

Abstract PDF: No abstract available.

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