Orthopedics. 2021 Jul-Aug;44(4):e583-e587. doi: 10.3928/01477447-20210618-21. Epub 2021 Jul 1.
Several anatomic plates for fixation of the olecranon after a fracture or an osteotomy are commercially available. They serve as an alternative for tension band wiring, which is associated with a relatively high complication rate. Plating of the olecranon reportedly might result in nonunion or malunion and eventually may require revision surgery or plate removal because of skin irritation. The authors describe a proximal periprosthetic avulsion fracture of the tip of the olecranon as a unique complication associated with the use of an anatomic plate for fixation of an olecranon osteotomy. This retrospective case series included 35 patients with comminuted distal humerus fractures treated by open reduction and internal fixation through an olecranon osteotomy with an anatomic olecranon plate. Of the 35 patients, 6 (17.1%) had postoperative olecranon tip fracture, just proximal to the osteotomy site. In all cases, the fracture line coursed through the proximal cluster of screws situated on the proximal part of the plate. Avulsion fractures of the tip of the olecranon after plating of the olecranon osteotomy could have occurred as a result of biomechanical factors. The short design of the proximal part of the plate and the high screw density in the proximal part of the olecranon could lead to increased mechanical stress during contraction of the triceps. This complication should prompt further biomechanical evaluation of the plate design. [. 2021;44(4):e583-e587.].
有几种解剖钢板可用于固定骨折或截骨术后的尺骨鹰嘴。它们可作为张力带钢丝固定的替代方法，后者与相对较高的并发症发生率相关。据报道，尺骨鹰嘴钢板固定可能导致不愈合或畸形愈合，最终可能因皮肤刺激而需要进行翻修手术或取出钢板。作者描述了一种独特的并发症，即与使用解剖钢板固定尺骨鹰嘴截骨术相关的近侧假体周围撕脱性鹰嘴尖端骨折。本回顾性病例系列纳入了 35 例通过鹰嘴截骨切开复位内固定治疗的粉碎性肱骨远端骨折患者，使用解剖鹰嘴钢板固定。在 35 例患者中，术后有 6 例（17.1%）发生鹰嘴尖端骨折，刚好位于截骨部位近端。在所有病例中，骨折线均通过位于钢板近端部分的近端螺钉簇。鹰嘴截骨术后行钢板固定发生鹰嘴尖端撕脱性骨折可能是生物力学因素所致。钢板近端部分的短设计和鹰嘴近端部分的高螺钉密度可能导致三头肌收缩时机械应力增加。这种并发症应促使进一步对钢板设计进行生物力学评估。[J Orthop Trauma. 2021;34(4):e583-e587.]。
