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Archives of Orthopaedic and Trauma Surgery

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Open Access 05-07-2021 | Olecranon Fracture | Trauma Surgery

Retrospective comparison of conservative treatment and surgery for widely displaced olecranon fractures in low-demanding geriatric patients

Authors: Peter Kaiser, Kerstin Stock, Stefan Benedikt, Tobias Kastenberger, Gernot Schmidle, Rohit Arora

Published in: Archives of Orthopaedic and Trauma Surgery | Issue 10/2022

Abstract

Introduction

The aim of this study was to evaluate the difference of the clinical outcome of elderly patients who were treated surgically or conservatively for a displaced olecranon fracture (Mayo type IIA or IIB).

Patients and methods

Patients above the age of 70 years who were treated surgically (n = 11) for a displaced Mayo type IIA and IIB olecranon fracture between July 2015 and February 2019 were retrospectively compared with patients who were treated conservatively (n = 6). The range of motion, elbow strength, grip strength, VAS, DASH, OES, MEPI and Broberg and Morrey scores were evaluated.

Results

The conservative group showed a non-union with a persistent fracture gap of 17 mm (SD 12 mm) at the articular rim and 31 mm (15 mm) at the dorsal rim while there was no case of non-union in the surgical group. The arch of motion was 120° in the conservative group and 136° in the surgical group. There was no obvious difference in elbow extension strength in comparison to the healthy contralateral side (p = 0.20; 88% group I/87% group II). There was no difference in the OES (p = 0.30; 42 (SD 7) vs. 45 (SD 5)) and MEPI score (p = 0.46; (SD 8) vs. 96 (SD 19)). The conservative group presented a slightly worse DASH [p = 0.10; 26 (SD 25) vs 7 (SD 14)] and a significantly worse Broberg and Morrey score (p = 0.02; 84(SD 9) vs. 95 (SD 7)). The conservative group presented one complication (ulnar nerve palsy), while the surgical group presented two cases (prolonged lymphedema; blocked forearm rotation due to screw length with consecutive revision surgery).

Conclusion

Widely displaced olecranon fractures can successfully be treated conservatively in low-demanding geriatric patients with a satisfactory outcome. Patient selection is essential as patients that are more active might benefit from surgical treatment. Yet, treatment risks and benefits need to be balanced carefully in regard to the patient`s demands and requests.

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Title: Retrospective comparison of conservative treatment and surgery for widely displaced olecranon fractures in low-demanding geriatric patients
Authors: Peter Kaiser
Kerstin Stock
Stefan Benedikt
Tobias Kastenberger
Gernot Schmidle
Rohit Arora
Publication date: 05-07-2021
Publisher: Springer Berlin Heidelberg
Keywords: Olecranon Fracture
Olecranon Fracture
Published in: Archives of Orthopaedic and Trauma Surgery / Issue 10/2022
Print ISSN: 0936-8051
Electronic ISSN: 1434-3916
DOI: https://doi.org/10.1007/s00402-021-04031-7

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Retrospective comparison of conservative treatment and surgery for widely displaced olecranon fractures in low-demanding geriatric patients

Abstract

Introduction

Patients and methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Patients and methods

Results

Conclusion

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