Plate osteosynthesis for severe olecranon fractures.

PURPOSE To review outcomes of 10 patients who underwent plate osteosynthesis for severe olecranon fractures. METHODS Records of 7 men and 3 women aged 33 to 73 years who underwent plate osteosynthesis for severe olecranon fractures were reviewed. All had some degree of soft-tissue injury; 6 presented with associated fractures. Seven patients were treated with a limited contact dynamic compression plate, and the remaining 3 received a locking compression plate. Patients were followed up for fracture healing, range of motion, nerve damage, heterotopic ossification, infection, hardware complaints, and the need of a secondary surgical procedure. The Mayo Elbow Performance Score (MEPS) was determined at the final follow-up. The patient-answered questionnaire (PAQ) portion of the Liverpool Elbow Score (LES) was evaluated 2 to 37 months later by telephone. RESULTS All patients had bone union. None had nerve damage or heterotopic ossification. Patients 4, 6, and 8 with type-IIIB fractures developed deep infections and severe soft-tissue swelling; all had been treated with the limited contact dynamic compression plate. Four patients underwent plate removal owing to hardware complaints. One patient underwent a secondary procedure to restore complete range of elbow motion. The mean MEPS score was 84 (range, 35-100); 5 patients attained excellent scores, one good, 2 satisfactory, and 2 unsatisfactory. The mean PAQ portion of the LES score was 31 (range, 23-36). CONCLUSION Plate osteosynthesis achieves satisfactory results for severe olecranon fractures. The deep infection rate is higher in patients with severe soft-tissue injury.