Surgical Treatment of Olecranon Fractures Using a Medartis Screw-Locked H-Shaped Plate (Medartis Trilock Olecrane Plate) at the Moulins Yzeure Hospital Center (France)

Introduction: Olecranon fractures represent approximately 10% of upper limb fractures, orthopedic treatment is often doomed to failure and surgical treatment consists of fixing the fracture sites. Patients and Methods: This study retrospectively analyzed 130 patients, 90 men and 40 women, aged on average 48.7 ± 11.9 years (30 to 65) treated between 2018 and 2020 in the Orthopedics and trauma department at the Moulins-Yzeure hospital center, for olecranon fracture using the Medartis H-locked plate. The study aimed to evaluate the results of this surgical method, particularly with regard to postoperative complications. Results: Among the 130 patients, there were 90 men and 40 women, with an average age of 48.7 ± 11.9 years (30 to 65). 50% of all patients were aged over 51 years. The plate used was standard, the same for the 130 patients with the same operating technique. The left side was more affected at 53.8%, the dominant side was less affected at 46%;the majority of patients had been temporarily immobilized with a posterior cast splint before surgery. The average time between trauma and operation was 9 days with a minimum time of 1 day and a maximum of 30 days. At a maximum follow-up of 2 years postoperatively, all patients reported satisfactory results with a return to their previous activities within 60 days after surgery. Conclusion: Medartis H-locked plate osteosynthesis is a reliable solution for the surgical treatment of olecranon fractures.

Long-term results of olecranon fractures treated using the XS nail® system

Purpose:Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces.Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition,as well as neutralizing the strain inhibiting fracture healing.The XS nail®(Intercus GmbH,Bad Blankenberg,Germany),an intramedullary implant exerting compression across the entire fracture surface,unlike plates,leaves a minimal extra-cortical profile,and can be secured with threaded locking wires,thereby retaining the anatomical reduction without displacement or steps within the articular surface,which was often found in tension band wiring.After encouraging initial results,the long-term outcome was assessed.Methods:This retrospective study evaluated the long-term outcome of patients surgically treated at our trauma center between January 2002 and December 2005 using the XS nail®.Patients over the age of 18 years eligible for the study must have undergone surgery for isolated,recent(less than 14 days)traumatic olecranon fractures,without concomitant injuries to the ipsilateral elbow and forearm.Further exclusion criteria were pseudarthrosis,re-fractures and osteotomy for distal humerus surgery,as well as polytraumatized patients unable to aid in their own recovery.Data were retrospectively gathered by standardised questionnaire and patient records,as well as surgery and anesthesiology reports.Data analysis was performed using Microsoft Office Excel?2016.Results:There were 32 patients,13 males(mean age 49.0 years)and 19 females(mean age 68.9 years)with 11 Schatzkers type D,7 each type A and C,5 type B and 2 type E at an average of 55.2 months,all showing complete consolidation.Of them,6 patients had a loss of range of motion with more than 10°in the sagittal plane,and only 1 patient exceeded 10°reduction of supination.Twenty-five patients reported being pain-free under all circumstances,and all but 2 patients(93.75%)had returned to their previous activity level.The average disabilities of the arm,shoulder and hand score was 21.15(range 0-88.3),and the overall Mayo elbow performance index was 91.87,without complications,such as wound infection,neurovascular impairment or premature hardware removal.Conclusion:Using the XS nail®system,all fracture types can be successfully treated and the rate of complications was lower than that treated by standard methods published in current literature.An excellent functional outcome,high range of motion as well as good retention of reduction without soft tissue irritation makes this a very suitable implant for fractures subject to tension.