Gutman Michael Jason, Patel Manan Sunil, Connelly James William, Paxton Edward Scott, Namdari Surena, Horneff John Gabriel
Rothman Orthopaedic Institute at Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Brown University, East Providence, Rhode Island, USA.
Arch Bone Jt Surg. 2025;13(1):23-29.
The purpose of this study is to evaluate the outcomes of a polyaxial locking plate utilizing locking-cap fixation for treatment of patients with displaced olecranon fractures.
A retrospective review was performed for all consecutive patients at two institutions with displaced olecranon fractures treated with a polyaxial locking plate. Patients were required to have at least 1-year follow up. Clinical outcomes including the Disabilities of the Arm, Shoulder, and Hand (DASH) score, Single Assessment Numeric Evaluation (SANE), along with a Likert-scaled satisfaction survey ranging between 1-5 (1= very unsatisfied and 5= very satisfied) were collected.
The plate osteosynthesis was performed on 24 patients with displaced olecranon fractures. Functional outcome scores were collected on 19 (79.2%) patients. The mean age at the time of surgery was 57.9 years (range, 23 to 78) and mean clinical follow-up was 21.0 ± 6.6 months (range, 12-34 months). All patients achieved osseous union in an acceptable position. Four (16.7%) patients complained of plate related pain and 6 (25%) patients complained of postoperative stiffness. Complications were found in 3 (12.5 %) patients, which included two neuropathies and one hardware failure in which a patient presented following a fall with a broken screw. No patients required revision surgery nor removal of hardware. A total of 16 (84%) patients were somewhat to very satisfied. The mean SANE score was 87.8 ± 14.6 (range: 45-100) and the mean DASH score was 13.8 + 17.5 (range: 0-55.8). Seventeen (89%) patients rated their elbows as 75% or better on SANE assessment and 16 (84%) patients achieved DASH scores of less than 30.
Polyaxial plate fixation utilizing locking-cap technology resulted in excellent short-term functional outcomes in patients with displaced olecranon fractures. Further follow-up is needed to determine the long-term outcomes of locking-cap constructs for olecranon fractures.
本研究旨在评估采用锁定帽固定的多轴锁定钢板治疗移位型鹰嘴骨折患者的疗效。
对两家机构中所有连续接受多轴锁定钢板治疗的移位型鹰嘴骨折患者进行回顾性研究。患者需至少随访1年。收集临床结果，包括手臂、肩部和手部功能障碍（DASH）评分、单项评估数字评定法（SANE），以及1至5分的李克特量表满意度调查（1 = 非常不满意，5 = 非常满意）。
对24例移位型鹰嘴骨折患者进行了钢板接骨术。收集了19例（79.2%）患者的功能结果评分。手术时的平均年龄为57.9岁（范围23至78岁），平均临床随访时间为21.0±6.6个月（范围12至34个月）。所有患者均在可接受的位置实现了骨愈合。4例（16.7%）患者抱怨与钢板相关的疼痛，6例（25%）患者抱怨术后僵硬。3例（12.5%）患者出现并发症，包括2例神经病变和1例内固定失败，其中1例患者跌倒后出现螺钉断裂。无患者需要翻修手术或取出内固定。共有16例（84%）患者有点满意至非常满意。平均SANE评分为87.8±14.6（范围：45至100），平均DASH评分为13.8 + 17.5（范围：0至55.8）。17例（89%）患者在SANE评估中对其肘部的评分达到75%或更高，16例（84%）患者的DASH评分低于30。
采用锁定帽技术的多轴钢板固定术在移位型鹰嘴骨折患者中产生了优异的短期功能结果。需要进一步随访以确定锁定帽结构治疗鹰嘴骨折的长期结果。
