Department of orthopaedic surgery and traumatology, Centre Hospitalier Métropole de Savoie, BP 31125, 73160 Chambéry cedex, France.
Department of orthopaedic surgery and traumatology, Centre Hospitalier Métropole de Savoie, BP 31125, 73160 Chambéry cedex, France.
Orthop Traumatol Surg Res. 2021 Dec;107(8):103089. doi: 10.1016/j.otsr.2021.103089. Epub 2021 Sep 30.
For displaced olecranon fractures, surgery is the standard of care in young adults but remains controversial in patients aged 75 years or over. The objective of this study was to assess the functional and radiological outcomes and to describe the complications of surgical treatment in this older population.
Surgery is the optimal treatment for displaced olecranon fractures in patients aged 75 years or over.
We retrospectively reviewed the files of patients who were 75 years of age or older when they underwent surgery for displaced olecranon fractures at our centre between January 2013 and December 2017. Functional and radiological outcomes were assessed at radiological fracture healing or at last follow-up.
We included 29 patients with 30 fractures. Mean age was 82 years (range, 75-93 years). All 30 fractures were Mayo II or III, A or B. Tension-band wiring was used for 21 fractures, locked-plate fixation for 7 fractures, and double-plate fixation for 2 fractures. The mean Mayo Elbow Performance Score was 82.5 (range, 45-100). Complications occurred for 11 (37%) fractures, and the material was removed for 11 (37%) fractures.
The complications resulted from a mismatch between fracture type, bone quality, and the internal fixation material. Compared to tension-band wiring, plate fixation was associated with more complications, many of which required removal of the material. Tension-band wiring was not sufficient for proximal fractures and type III B fractures, for which lacing is an alternative. Conservative functional treatment remains a wise option for type II olecranon fractures in these elderly patients. Surgery is required, however, in patients with type III fractures (fracture-dislocations).
IV, retrospective, single-centre, observational cohort study.
对于移位的尺骨鹰嘴骨折，手术是年轻患者的标准治疗方法，但在 75 岁及以上的患者中仍存在争议。本研究的目的是评估手术治疗在这一年龄段患者中的功能和影像学结果，并描述其并发症。
手术是 75 岁及以上移位尺骨鹰嘴骨折患者的最佳治疗方法。
我们回顾性分析了 2013 年 1 月至 2017 年 12 月期间在我院接受手术治疗的 75 岁及以上移位尺骨鹰嘴骨折患者的病历。在影像学骨折愈合或末次随访时评估功能和影像学结果。
共纳入 29 例 30 处骨折患者，平均年龄 82 岁（75-93 岁）。所有 30 处骨折均为 Mayo II 或 III 型，A 或 B 型。21 处骨折采用张力带钢丝固定，7 处骨折采用锁定钢板固定，2 处骨折采用双钢板固定。平均 Mayo 肘功能评分 82.5 分（45-100 分）。11 处（37%）骨折出现并发症，11 处（37%）骨折需取出内固定物。
并发症是由骨折类型、骨质量和内固定材料不匹配引起的。与张力带钢丝固定相比，钢板固定更易出现并发症，其中许多需要取出内固定物。张力带钢丝固定对于近端骨折和 IIIB 型骨折不适用，对于这些骨折，缝线固定是一种替代方法。对于这些老年患者的 II 型尺骨鹰嘴骨折，保守的功能治疗仍然是明智的选择。然而，对于 III 型骨折（骨折脱位），则需要手术治疗。
IV 级，回顾性、单中心、观察性队列研究。
