PLATE FIXATION FOR OLECRANON FRACTURES (PROXIMAL ULNA)

Background: Complex fractures of olecranon with severe comminution have become more frequent in the recent years. However, these fractures still remain a treatment challenge for trauma surgeons. To allow early functional mobilization and to prevent stiffness of the elbow joint, the fracture fixation has to provide secure stability. Especially for severely comminuted olecranon fractures, fractures including the coronoid process and Monteggia fracture dislocations, plate fixation have evolved as gold a standard treatment. Objective: To investigate the efficacy of plate fixation of comminuted olecranon fractures in achieving good functional result measured by Mayo Elbow Performance score (MEPS) , union and range of motion. Patients and methods: A prospective case series was conducted at BeniSuefGeneralizedHospital on patients with comminuted olecranon fractures presenting to the emergency department. The study included fifteen patients, all of whom were treated by open reduction and internal fixation (ORIF) using anatomical locked plate, during the period from February 2020 to March 2021. All patients followed the same postoperative and rehabilitation program allowing early range of motion. The mean follow up period was 4 months. Patients were evaluated for functional outcome using MEPS, range of motion, union and secondary procedure rate. Results: After 4 months, the average range of motion was 106° ±19.57° with a mean extension loss of 16.67° ± 12.91° and mean flexion range of 122.67° ± 7.99° .The mean functional score was 87.67 ± 13.61 with 86% of cases achieving good or excellent outcomes. 93.3% of patients united, and 6.6% required secondary grafting with no cases of hardware breakage, or fracture displacement. The secondary procedure rate was 12.5%. Conclusion: Anatomically preshaped locking compression plate (LCP) was an effective fixation method for comminuted fractures of the olecranon allowing reliable stability for early elbow motion.