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Lingayat, Maruti B., Altamash Patel, and Chandrakant R. Thorat. "Short-term functional results of surgical management of fractures of olecranon process of ulna by locking hook plate." International Journal of Research in Orthopaedics 7, no. 5 (2021): 959. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20212915.
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<p class="abstract"><strong>Background:</strong> The aim was to study functional results of fixation of fractures of olecranon process of ulna by locking hook plate.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on 30 patients who underwent fixation of olecranon fracture by locking hook plate in department of orthopaedics, GMCH Aurangabad from September 2018 to September 2020. Patients were assessed functionally using Mayo elbow performance score and radiologically using serial follow up radiographs of elbow.<strong></strong></p><p class="abstract"><strong>Results:</strong> At 2 year follow up of 30 patients of all types of olecranon fracture treated by locking hook plate, no patient had evidence of non-union or loss of reduction or any other major complications. In our study 21 patients (70%) showed excellent results, 6 patients (20%) showed good results and 3 patients (10%) showed fair results. None of the patients in our study showed poor results. 3 patients (10%) had superficial infection which were treated by adequate antibiotics after doing culture and sensitivity testing and 4 patients (13.33%) had symptomatic metal prominence which underwent implant removal after union of fracture.</p><p><strong>Conclusions:</strong> Fixation of all types of fractures of olecranon by locking hook plate is good alternative to other methods of fixation like tension band wiring, intramedullary fixation using screw tension band wiring which are used only in selected cases. In our study we conclude that locking hook plate is excellent modality of treatment for all types of fractures of olecranon, it gives excellent functional and radiological outcome with minimal complication and stable fixation of all types of fractures including transverse as well as comminuted fractures.</p>
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M, Venkata Swamy, and Rammohan K. "Clinical Study on Functional Outcome after Surgical Management for Olecranon Fractures." International Journal of Pharmaceutical and Clinical Research 16, no. 3 (2024): 413–18. https://doi.org/10.5281/zenodo.10957986.
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<strong>Background: </strong>Olecranon fractures represent a relatively frequent occurrence, comprising roughly 10% of all upper extremity fractures and 40% of fractures in the vicinity of the elbow joint. These fractures commonly stem from direct or indirect trauma, frequently associated with forced hyperextension of the elbow joint. In cases of non-displaced olecranon fractures, a conservative management strategy is often appropriate. The objective of this prospective study was to evaluate the functional outcomes resulting from anatomical plate fixation for olecranon fractures, encompassing both simple and comminuted cases. <strong>Methods: </strong>A total of n=20 cases of olecranon fractures were included in the study based on the inclusion and exclusion criteria. The treatment approach involved using tension band wiring with Kirschner wires for simple transverse fractures and an olecranon hook plate for comminuted fractures and a strong focus on clinical observation and the subsequent analysis of outcomes following surgical management of olecranon fractures using Kirschner wires with tension band wiring and olecranon hook plates. <strong>Results: </strong>In this study 15(75%) cases were with excellent scores of 90 – 100. N=3(15%) cases had good scores of 80 – 89. The scores of 70-79 are considered fair in this study in 2(10%), cases. The scores below 60 are considered poor or unacceptable no case in this study were with scores below 60. In this study, the total number of complications was in 2(10%) cases which included 2 cases of superficial infections that were adequately managed by antibiotics. <strong>Conclusion:</strong> The current study concludes that the application of open reduction and internal fixation, utilizing Kirschner wires and tension band wiring for simple transverse and oblique fractures, along with olecranon plate fixation for comminuted fractures, proves to be an effective and established approach. 70% of patients in this study achieved excellent Mayo Elbow Performance Scores (MEPS), while an additional 20% obtained good MEPS scores. Significantly, none of the study participants demonstrated poor or unacceptable MEPS scores. These results indicate a notable success rate in the management of olecranon fractures, with the majority of patients realizing favorable and excellent functional outcomes.
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Kapila, R., A. Chauhan, B. Rai, D. Kumar, and Maasha. "A Comparative Study on Management of Olecranon Fracture Using Tension Band Wiring and Olecranon Hook Plate." International Journal of Pharmaceutical and Clinical Research 16, no. 6 (2024): 95–104. https://doi.org/10.5281/zenodo.12707517.
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<strong>Objective: </strong>To compare the results of tension band wiring (TBW) v/s Olecranon hook plate fixation in management of fracture olecranon in terms of time taken for fracture union and clinical, functional and radiological outcome. <strong>Methods:</strong> 30 patients suffering from olecranon fracture were enrolled and study was carried out in Department of Orthopaedics, Guru Nanak Dev Hospital and College, Amritsar. <strong>Results:</strong> It was observed that among the cases mean age was 42.4 years. The study reported more number of males than females. The subjects were categorized into 2 groups. In both the groups, fractures on right side were involved more than left side. The road side accident was the commonest mode of injury to cause fracture. In both groups most common fracture type was type IIA (50%). Majority of the cases 19 (63.3%) were operated within 24 hours. 4 (13%) cases associated with fracture of femur bone required hemodynamic stabilization/surgery on priority basis. Other complications entails fracture in shaft femur and inter-trochantric femur. Mean MEPS in group A was 86.9 and in group B was 89.1. <strong>Conclusion:</strong> It was found that tension band wiring and plate fixation are equally effective in management of displaced olecranon fractures.
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Mahajan, Pranav, Ishan Khanna, Kundan Kushwah, and Kanhaiya Yadav. "A comparative study of outcome of tension band wiring and hook plating in fracture olecranon." International Journal of Research in Orthopaedics 9, no. 3 (2023): 519–24. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20231176.
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Background: Olecranon fractures are common upper limb fracture accounting for 40% of the fractures around elbow. Anatomic reduction and restoration of the joint surface is required for good outcome and to prevent post-traumatic arthritis. This study was directed towards the functional results and complications of surgical management of olecranon fracture treated with hook plate fixation and tension band wiring. Methods: This prospective comparative study was done at a tertiary care centre from 2019 to 2022. This study consisted of 30 patients of fracture olecranon of which 15 were treated with tension band wiring and 15 with hook plate. All patients were followed up with minimum follow up of six months and evaluated for their functional outcome using Mayo elbow performance score. Results: In this study, the average age was 34 years in TBW group and 37 years in hook plate group. The mean Mayo elbow performance score after 6 months in TBW group was 88.33 (excellent) and in plate group was 90 (excellent). Superficial infection was present in 2 patients of the TBW group. Elbow stiffness was present in 2 patients of TBW group. Hardware impingement was present in one patient in each of TBW group and plate group. Conclusions: To achieve early movements and to prevent complications like traumatic arthritis and joint stiffness we need a perfect anatomical reduction in intra-articular fractures of the olecranon. This study showed no significant difference in functional outcome with both the techniques, but the complications are more with TBW.
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Zufahrizzat, S., AS Nadzim, O. Saifudin, and Rauf A. Abdul. "TENSION BAND WIRING (TBW) OF DISTAL END CLAVICLE : A FORGOTTEN TECHNIQUE : SIMPLER, CHEAPER AND BETTER." Orthopaedic Journal of Sports Medicine 8, no. 5_suppl5 (2020): 2325967120S0006. http://dx.doi.org/10.1177/2325967120s00066.
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Clavicle fracture is a common injury, and can be classified into middle third, medial third, and distal third fractures. Only 10-15% of clavicle fracture occur in the distal third segment. Neer classified the distal clavicle fracture into five types ; type II and V are unstable and requiring fixation . Various common methods of stabilizations are introduced such as K-wiring , tension band fixation , plate fixation, osteosynthesis with hook plate and coracoclavicular screw however all those operative methods have their own advantages and disadvantages. Materials and Methods: We presented a case of 21 years old male with left shoulder pain after motor vehicle accident. Examination revealed tenderness on his left shoulder, and radiograph showed fracture of distal end left clavicle Neer type II, requiring fixation. He was counselled for lateral extension clavicle locking plate but unable to pay due to financial constraint. Results: The patient underwent open reduction and internal fixation using Kirschner wire with tension band fixation . The fracture site was visualized and the hematoma was curetted and washed. The fracture was reduced and fixed with two 1.4 mm trans-acromial Krischner wires and the reduction was checked with an image intensifier. Then the TBW is applied using stainless steel wire size 1.0 . The K-wires are bent beneath the skin. Sling immobilization is used for 2 weeks after the operation. Unrestricted tolerable shoulder motion is permitted. Stretched and exertional exercise is allowed after radiography shows osseous union and the implants are removed. Discussions: TBW is widely employed to treat limb fractures, such as patella and olecranon fracture but seldom used for distal clavicle nowadays. The advantages of TBW are higher antirotation and antibending force compared with that in K-wire fixation and lower profile compared with the bone plate, which reduces tendon irritation and prominent implant. The use of K-wires and TBW also required only the exposure of the fracture site. The soft tissue around the clavicle incurred little damage, leading to a lower infection rate. In addition, the use of K-wires and TBWs can provide a more rigid fixation than K-wires only. Rigid fixation with little complication contributes to good results . Conclusion: Surgical management is recommended for unstable distal clavicle fracture. TBW can be preferred because of the simplicity of the procedure, low cost, simple hardware, high union rate and easy availability of the implant.
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Ocalan, Halil Ibrahim, Ozgun Karakus, and Gunhan Karakurum. "Comparison of olecranon fixation techniques following transolecranon approach in intra-articular fractures of distal humerus in adult patients." Journal of Orthopaedics, Trauma and Rehabilitation 27, no. 1 (2019): 33–39. http://dx.doi.org/10.1177/2210491719884944.
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Background: In this study, we assessed functional outcomes among olecranon fixation techniques used following transolecranon approach in patients with comminuted fracture of distal humerus. Methods: The study included 37 elbows that underwent olecranon osteotomy due to distal humerus fracture. Functional outcomes were assessed among patients who underwent fixation via tension band technique, plate, or screw fixation. Results: The implant irritation was seen in 18% of patients who underwent K-wire plus tension band fixation, in 75% of patients who underwent olecranon plate plus screw fixation, and in 18% of patients who underwent cancellous screw fixation. The rate for implant removal was 2.6 folds lower in K-wire plus tension band fixation when compared to olecranon plate plus screw fixation. Conclusion: We concluded that K-wire plus tension band technique and cancellous screw fixation performed in accordance with technical principles caused less skin problem when compared to other techniques. In olecranon fixation, both methods with enhanced stability by tension band can be preferred.
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Schneeberger, A. G. "Plate Fixation of Olecranon Osteotomies." Yearbook of Hand and Upper Limb Surgery 2008 (January 2008): 69–70. http://dx.doi.org/10.1016/s1551-7977(08)79140-4.
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Hewins, Edward A., Wade T. Gofton, Jamie Dubberly, Joy C. MacDermid, Kenneth J. Faber, and Graham JW King. "Plate Fixation of Olecranon Osteotomies." Journal of Orthopaedic Trauma 21, no. 1 (2007): 58–62. http://dx.doi.org/10.1097/01.bot.0000246467.32574.fe.
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Boden, Allison L., Charles A. Daly, Poonam P. Dalwadi, et al. "Biomechanical Evaluation of Standard Versus Extended Proximal Fixation Olecranon Plates for Fixation of Olecranon Fractures." HAND 14, no. 4 (2018): 554–59. http://dx.doi.org/10.1177/1558944717753206.
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Background: Small olecranon fractures present a significant challenge for fixation, which has resulted in development of plates with proximal extension. Olecranon-specific plates with proximal extensions are widely thought to offer superior fixation of small proximal fragments but have distinct disadvantages: larger dissection, increased hardware prominence, and the increased possibility of impingement. Previous biomechanical studies of olecranon fracture fixation have compared methods of fracture fixation, but to date there have been no studies defining olecranon plate fixation strength for standard versus extended olecranon plates. The purpose of this study is to evaluate the biomechanical utility of the extended plate for treatment of olecranon fractures. Methods: Sixteen matched pairs of fresh-frozen human cadaveric elbows were used. Of the 16, 8 matched pairs received a transverse osteotomy including 25% and 8 including 50% of the articular surface on the proximal fragment. One elbow from each pair was randomly assigned to a standard-length plate, and the other elbow in the pair received the extended-length plate, for fixation of the fracture. The ulnae were cyclically loaded and subsequently loaded to failure, with ultimate load, number of cycles, and gap formation recorded. Results: There was no statistically significant difference between the standard and extended fixation plates in simple transverse fractures at either 25% or 50% from the proximal most portion of the articular surface of the olecranon. Conclusion: Standard fixation plates are sufficient for the fixation of small transverse fractures, but caution should be utilized particularly with comminution and nontransverse fracture patterns.
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Twu, Jonathan, David C. Landy, and Jennifer Moriatis Wolf. "Olecranon Fracture through Persistent Olecranon Apophysis in a 21-Year-Old Male: A Case Report and Systematic Review of the Literature." Journal of Hand Surgery (Asian-Pacific Volume) 25, no. 01 (2020): 110–13. http://dx.doi.org/10.1142/s2424835520720017.
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Traumatic fractures involving an ununited olecranon apophysis in adults have been rarely documented in the literature. We present the case of a 21-year-old male wrestler with an elbow injury after a fall. Imaging revealed an acute fracture of the olecranon with sclerotic rounded edges indicating an injury through a persistent olecranon apophysis. Open reduction and internal fixation was performed with plate fixation and bone grafting with radiographic and clinical healing at 6 weeks. Review of the literature revealed 5 case reports showing high rates of non-union with tension band constructs while plate and screw fixation had no incidence of nonunion. Fractures through an ununited olecranon apophysis are successfully treated with plate and screw fixation with bone grafting.
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Lee, Eunchang, Seong-Hee Cho, Jun-Il Yoo, Jin-Hyung Im, Dong-Geun Kang, and Jin Sung Park. "Surgical Treatment of Comminuted Olecranon Fracture Using Locking Compression Plate Fixation." Archives of Hand and Microsurgery 26, no. 1 (2021): 18–26. http://dx.doi.org/10.12790/ahm.20.0078.
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Purpose: Several types of surgical methods from tension band wiring to plate fixation are used in olecranon fractures. In comminuted olecranon fractures, plate fixation is recommended as it is difficult to obtain stable fixation of the bone fragments and joint congruency. The authors performed operations using compression locking plate for olecranon fractures corresponding to Mayo classification IIB and IIIB, and report the radiologic and functional results.Methods: Twenty-one patients who underwent plate fixation surgery for comminuted olecranon fractures at our hospital from September 2011 to April 2019 were enrolled in this study. Patients were retrospectively analyzed for at least 1 year. The classification of olecranon fracture was performed using the Mayo classification. For the analysis of the postoperative results, radiological union time, postoperative range of motion, complications, and functional results based on Mayo elbow performance score (MEPS) were evaluated.Results: The union was achieved in all cases and three posttraumatic arthritis were observed at the final follow-up. The average range of motion was 134.3° in flexion, –9.8° in extension. The mean MEPS was 93.1. There was no statistically significant difference in MEPS between the group that used technique of interfragmentary fixation and the group that did not (p=0.534).Conclusion: Surgical treatment using a locking compression plate fixation in comminuted olecranon fracture resulted in excellent functional results. Restoration of articular surface using Kirschner wire or interfragmentary screw between small bone fragments is considered a useful method for obtaining good functional results.
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Wu, Shuang, Jialei Chen, Jie Zhang, et al. "Hook plate fixation with versus without coracoclavicular reconstruction for distal clavicular fractures." Journal of Orthopaedic Surgery 30, no. 1 (2022): 102255362210886. http://dx.doi.org/10.1177/10225536221088630.
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Purpose Hook plate fixation is one of the most frequently used methods for unstable distal clavicular fractures, but it is still unknown if there is a need for coracoclavicular (CC) reconstruction. This study aimed to compare the efficacy of hook plate fixation with versus without CC reconstruction for distal clavicular fractures. Methods Eighty-one patients who underwent hook plate fixation (HP group, n = 45) or hook plate fixation plus suture anchor reconstruction (HPA group, n = 36) for Neer type II or V clavicular fractures were enrolled. Demographics, fracture characteristics, and surgical data were recorded. Union time, coracoclavicular distance (CCD), post-operative complications, Constant score, and Disabilities of the Arm, Shoulder, and Hand (DASH) score were compared between HPA and HP groups. Results Constant score in the HPA group was higher than that in the HP group (91.8 ± 3.6 vs 88.8 ± 6.0, P = 0.007). However, there were no significant differences in union time, DASH score, CCD, and post-operative complications between the two groups (P > 0.05). Hook plate fixation combined with CC reconstruction costed more (3023.7 ± 202.6 vs 2416.2 ± 167.6 EUR, P < 0.001) and prolonged operative duration (78.2 ± 9.2 vs 73.7 ± 8.3 min, P = 0.023) compared with hook plate fixation alone. Conclusion Hook plate fixation with or without suture anchor reconstruction achieved satisfactory outcomes for Neer type II or V clavicular fractures. However, hook plate fixation plus CC reconstruction showed better functional outcomes compared with hook plate fixation alone.
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Wu, Shuang, Jialei Chen, Jie Zhang, et al. "Hook plate fixation with versus without coracoclavicular reconstruction for distal clavicular fractures." Journal of Orthopaedic Surgery 30, no. 1 (2022): 102255362210886. http://dx.doi.org/10.1177/10225536221088630.
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Purpose Hook plate fixation is one of the most frequently used methods for unstable distal clavicular fractures, but it is still unknown if there is a need for coracoclavicular (CC) reconstruction. This study aimed to compare the efficacy of hook plate fixation with versus without CC reconstruction for distal clavicular fractures. Methods Eighty-one patients who underwent hook plate fixation (HP group, n = 45) or hook plate fixation plus suture anchor reconstruction (HPA group, n = 36) for Neer type II or V clavicular fractures were enrolled. Demographics, fracture characteristics, and surgical data were recorded. Union time, coracoclavicular distance (CCD), post-operative complications, Constant score, and Disabilities of the Arm, Shoulder, and Hand (DASH) score were compared between HPA and HP groups. Results Constant score in the HPA group was higher than that in the HP group (91.8 ± 3.6 vs 88.8 ± 6.0, P = 0.007). However, there were no significant differences in union time, DASH score, CCD, and post-operative complications between the two groups (P > 0.05). Hook plate fixation combined with CC reconstruction costed more (3023.7 ± 202.6 vs 2416.2 ± 167.6 EUR, P < 0.001) and prolonged operative duration (78.2 ± 9.2 vs 73.7 ± 8.3 min, P = 0.023) compared with hook plate fixation alone. Conclusion Hook plate fixation with or without suture anchor reconstruction achieved satisfactory outcomes for Neer type II or V clavicular fractures. However, hook plate fixation plus CC reconstruction showed better functional outcomes compared with hook plate fixation alone.
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Mahajan, Neetin P., Mrugank A. Narvekar, Lalkar L. Gadod, and G. S. Prasanna Kumar. "Comminuted olecranon fractures: locking compression plate fixation verses conventional plate fixation." International Journal of Research in Orthopaedics 7, no. 5 (2021): 1001. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20213382.
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<p class="abstract"><strong>Background:</strong> A variable consensus exists on the optimal management strategies for olecranon fractures. Though the mechanical properties of the conventional plates and the locking plates used show no difference, pre-contoured locking plates provide a significant advantage over non-locking plates in unstable fractures. The aim of the study was to compare clinical and radiological outcomes in the management of the comminute olecranon fractures by anatomically pre-contoured locking compression plates and the conventional plates.</p><p class="abstract"><strong>Methods:</strong> The present study was a prospective study of 50 patients with comminuted olecranon fracture, with 25 patients each randomized into two groups, those that underwent fixation of the fracture using a pre-contoured locking compression plate (group LCP) and those fixed using a conventional plate (3.5 mm reconstruction plate) (group CP). Patients were followed up to 1 year with functional outcome assessed at each follow-up with Mayo elbow performance score.<strong></strong></p><p class="abstract"><strong>Results:</strong> The mean MEPS (LCP vs CP) at 1.5 (47 vs. 43.4) and 3 (67.4 vs 61.6) months follow up showed a statistically significant difference between the two groups, but the difference was not significant at 6 (86.4 vs 85.6) and 12 (88.4 vs 87) months. The time to union (4.3 months vs 5.0 months) was not significantly different between the groups. There were 11 complications in group LCP and 12 complications in group CP.</p><p class="abstract"><strong>Conclusions:</strong> In the present study, we suggest that the use of a pre-contoured locking compression plate provides better outcomes at earlier periods as compared to the conventional plate; thus, returning the patient to normal function at the earliest.</p>
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Ramawan, Erwin, and Jifaldi Afrian MDS. "BIOMECHANICAL COMPARATIVE STUDY BETWEEN TENSION BAND WIRING, DOUBLE ENDO BUTTON AND HOOK PLATE FOR ACROMIOCLAVICULAR JOINT INJURY." (JOINTS) Journal Orthopaedi and Traumatology Surabaya 7, no. 1 (2019): 65. http://dx.doi.org/10.20473/joints.v7i1.2018.65-76.
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Background: The treatment for acromioclavicular joint injury are debatable, there are fixation options include tension band wiring, AC joint reconstruction and hook plate These fixations are capable of providing a stable fixation, but controversy still exists that mentions the superiority of each of these fixationsPurpose: To compare biomechanical stability of 3 fixation include tension band wiring, double endo button, and hook plate to provide a scientific basis of the fixation.Methods: This research is an experimental in vitro. Using 27 acromioclavicular joints cadaver divided into three groups that performed tension band wiring fixation, double endo button and hook plate. Each fixation evaluated with 10, 20, 50 and 100 times repetitions with 100N traction force.Results: Tension band wiring gives the smallest displacement. In 10 times repetition average displacement of tension band wiring 0.056 mm (p = 0.000) compared to double endo button 1.622 mm and hook plate 0.867 mm. In 20 times repetitions, tension band wiring 0.1667 mm (p = 0,000) compared to double endo button 3.1778 mm and hook plate 1.1111 mm. In 50 times repetition, tension band wiring 0.3111 mm (p = 0.000) with double endo button 4.7778 mm and hook plate 1.3556 mm. In 100 times repetitions, tension band wire 0.556 mm (p = 0.000) while double endo button 5.4444 mm and hook plate 1.4556 mm.Conclusion: Tension band wiring have a good stability compared to double endo button and hook plate. But all of fixation provide stability for acriomioclavicular joint motion.
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Anderson, Meredith L., A. Noelle Larson, Sheri M. Merten, and Scott P. Steinmann. "Congruent Elbow Plate Fixation of Olecranon Fractures." Journal of Orthopaedic Trauma 21, no. 6 (2007): 386–93. http://dx.doi.org/10.1097/bot.0b013e3180ce831e.
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Bailey, Christopher S., Joy MacDermid, Stuart D. Patterson, and Graham J. W. King. "Outcome of Plate Fixation of Olecranon Fractures." Journal of Orthopaedic Trauma 15, no. 8 (2001): 542–48. http://dx.doi.org/10.1097/00005131-200111000-00002.
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Hong, In-Tae, Kyunghun Jung, Yoon Seok Kim, and Soo-Hong Han. "The Result of Locking Compression Plate Olecranon Plate Fixation for Unstable Comminuted Olecranon Fracture." Archives of Hand and Microsurgery 24, no. 2 (2019): 133. http://dx.doi.org/10.12790/ahm.2019.24.2.133.
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Phadnis, Joideep Sunil, Alex Vaughan, Toni Luokkala, Jonathon Peters, Jay J. Watson, and Adam Watts. "Comparison of all suture fixation with tension band wiring and plate fixation of the olecranon." Shoulder & Elbow 12, no. 6 (2019): 414–21. http://dx.doi.org/10.1177/1758573219831662.
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Background Tension band wiring and plate fixation are common techniques used to stabilize simple olecranon fractures and osteotomies of the olecranon. All suture fixation is an alternative technique but has not been compared previously to these traditional methods. The aim of this study was to compare the clinical and radiographic outcomes of the three techniques. Methods One hundred and sixty-eight consecutive Mayo type 1 and 2 olecranon fractures (n = 138) and olecranon osteotomies (n = 30) with a minimum follow-up time of one year were compared. The primary outcome measure was the rate of re-operation. Secondary outcome measures were the incidence of complications, rate of radiographic union and incidence of radiographic reduction loss. Results Fixation was performed using tension band wiring in 89 patients, plating in 38 patients and suture fixation in 41 patients. There was no significant difference in the fracture type according to the Mayo classification between the groups. The re-operation rate was significantly higher in the tension band wiring group (36%) compared with both the plate group (11%, p = 0.03) and the suture group (2%, p = 0.002). There were two revision fixations in the tension band wiring group and one in the suture group. There was one asymptomatic non-union in the suture group. All other fractures and osteotomies achieved radiographic union. Conclusion Suture fixation of simple olecranon fractures and osteotomies was reliable in providing stable union and had a significantly lower re-operation rate when compared with tension band wiring.
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Mahajan, Rahul, Nitin Choudhary, Sanjeev Gupta, and Neeraj Mahajan. "INTRA-ARTICULAR FRACTURES OF DISTAL HUMERUS MANAGED WITH ANATOMIC PRE-CONTOURED PLATES VIA OLECRANON OSTEOTOMY APPROACH." International Journal of Advanced Research 10, no. 05 (2022): 1288–94. http://dx.doi.org/10.21474/ijar01/14848.
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The treatment for displaced intra-articular fractures of the distal humerus is open reduction and internal fixation with early rehabilitation. Best exposure of both columns and articular surface of the distal humerus is achieved through olecranon osteotomy approach and fixation of two columns of distal humeruswith orthogonal plate construct which will allow absolute stability and early rehabilitation to restore early elbow joint function. 16 cases of intra-articular fractures of distal humerus were treated by open reduction and internal fixation (ORIF) with orthogonal plate construct via olecranon osteotomy approach. Chevron type olecranon osteotomy was performed and fixed with tension band wiring using 6mm CCS and SS wires in all cases. Radiological evaluationand regular clinical examination were done as per Mayo elbow Performance score. All fractures united within average duration of 3 months. More than 1000 range of motion is attained in 14 of cases. The mean Mayo Elbow Performance Score was 90.01 indicating excellent results. The factors for a successful outcome of intra-articular fractures of the distal humerus depends upon anatomic reduction, surgical technique, stable internal fixation, and early rehabilitation. ORIF with orthogonal plate construct securing both humeral columns via olecranon osteotomy approach results in excellent healing and functional outcomes.
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Pani, Sunit Kumar, Subrat Mohapatra, Spandan Mishra, Ramanuj Acharya, and Chaitanya Khandelwal. "A Rare Complication of Hook Plate Fixation for Lateral Clavicle Fractures: Salvage Management with K-Wire Fixation." Journal of Orthopaedic Case Reports 15, no. 2 (2025): 76–79. https://doi.org/10.13107/jocr.2025.v15.i02.5234.
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Introduction: Hook plate fixation is a widely used technique for managing lateral clavicle fractures, particularly when the coracoclavicular ligaments are disrupted. However, improper placement of the hook plate can result in rare and challenging complications that require innovative management strategies. This report presents a unique case involving such a complication and describes a minimally invasive, single-stage salvage approach using K-wire fixation to effectively address the issue. Case Report: A 45-year-old female presented with pain and restricted shoulder function due to a hook plate positioned incorrectly at the fracture site rather than in the acromioclavicular joint. The mispositioned plate was carefully removed, and the fracture was stabilized using K-wire fixation. Results: At the 6-month follow-up, the patient had excellent functional recovery with a Constant–Murley score of 89 and complete radiographic union at the fracture site. Conclusion: This case highlights a rare issue that can occur when a hook plate is not placed correctly. It shows how important it is to position hardware accurately. The case also illustrates how a minimally invasive technique, using K-wire stabilization, can effectively manage these types of complications. Keywords: Hook plate, clavicle, K-wire.
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Amit, Kumar, Ahmad Wasim, and Kumar Santosh. "Analysis of Functional Outcome of Pre-Contoured Olecranon Locking Plate in Fractures of the Olecranon." International Journal of Pharmaceutical and Clinical Research 16, no. 5 (2024): 1717–20. https://doi.org/10.5281/zenodo.12763691.
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<strong>Background: </strong>Olecranon fracture can be caused by direct trauma such as fall on the elbow or by indirect trauma such as falling on partially flexed elbow, with indirect forces by the triceps muscle avulsing the olecranon. Present study aims to analysis the functional outcome of precontoured olecranon locking plate for fractures of the olecranon. <strong>Methods:</strong> Present study was conducted at Orthopaedics department of IGIMS, Patna, Bihar from January 2014 to December 2014. This study was performed on thirty one skeletally mature patients with displaced fractures of the olecranon. Open reduction and internal fixation of displaced olecranon fracture of ulna with pre contoured olecranon locking plate. Patients were assessed by measuring the range of motion and Mayo Elbow Performance Score (MEPS) and index (MEPI). Serial radiographs were reviewed preoperatively for fracture classification and associated fractures, immediately postoperatively, and at the time of final review for adequacy and maintenance of reduction, evidence of union and arthritis. <strong>Results:</strong> At 1 year of follow up the mean flexion of elbow was 123.7° (range 90-130°), while the mean extension was 5.64° (range 0-30°). The MEPS index showed 1patient having fair result, 6 patients having good results and 24 patients having excellent results. None of the patients had poor results. The mean MEPS were 90.65. All patients showed full radiological union. <strong>Conclusion: </strong>‘Pre-contoured Olecranon Locking Plate’ provides rigid internal fixation allowing vigorous early mobilization at the elbow, especially in comminuted fractures of the olecranon. It shows an excellent rate of radiological union. There was no case of implant failure in our study, even in comminuted fractures, which can be attributed to the use of locking compression plates. Thus it is a viable alternative to other forms of fixation of olecranon fractures and is a versatile implant which can be used in all types of olecranon fractures with minimal complication rate.
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Seo, Joong-Bae, Kwon-young Kwak, and Jae-Sung Yoo. "Comparative analysis of a locking plate with an all-suture anchor versus hook plate fixation of Neer IIb distal clavicle fractures." Journal of Orthopaedic Surgery 28, no. 3 (2020): 230949902096226. http://dx.doi.org/10.1177/2309499020962260.
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Background: The coracoclavicular fixation with suture anchors adds stability to type IIb distal clavicle fractures fixed with a plate and screws when loaded to failure. The purpose of this study was to compare the clinical and radiological outcomes between the use of a locking compression plate (LCP) with all-suture anchor fixation and hook LCP fixation of Neer IIb distal clavicle fractures. Methods: A total of 82 consecutive patients who underwent plate fixation for Neer IIb distal clavicle fractures were included. The subjects were divided into two groups: an LCP with all-suture anchor fixation group and hook LCP fixation group. For clinical assessments, the American Shoulder and Elbow Surgeons score, Korean shoulder score (KSS), and Constant score were recorded. A percentage of the coracoclavicular distance (CCD%) was used to evaluate fracture reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, stiffness, peri-anchor osteolysis, postoperative acromioclavicular joint arthrosis, nonunion, or delayed union, were also analyzed. Results: There were no differences in the clinical and radiological outcomes at the final follow-up between the two groups. The period for bone union and CCD% showed no significant differences between groups. Stiffness at 3 months after surgery of LCP with all-suture anchor fixation ( n = 3, 10.7%) was less than that of hook LCP fixation ( n = 17, 31.5%). The complication rate also showed no significant differences between groups. However, LCP with all-suture anchor fixation had anchor-related complications, although it can reduce hook-related complications. Conclusion: LCP with all-suture anchor fixation showed satisfactory outcomes in comparison with hook LCP fixation. In Neer IIb distal clavicle fractures, LCP with all-suture anchor fixation is a useful method for the maintenance of reduction, avoiding implant removal, and hook-related complications. However, anchor fixation should be carefully used, especially in osteoporotic patients or patients with underlying diseases. Level of Evidence: Level III, retrospective study.
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Li, Yihan, Qingxian Tian, Kunpeng Leng, and Meng Guo. "Risk factors for clavicular midshaft fractures after hook plate fixation for the treatment of Neer type II clavicular fractures." Journal of International Medical Research 49, no. 8 (2021): 030006052110358. http://dx.doi.org/10.1177/03000605211035898.
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Objective Neer type II fractures are common, and hook plate fixation is one of the recommended treatments. Although clavicular midshaft fractures after hook plate fixation are rare, such fractures increase patients’ suffering and worsen their functional outcomes. This study was performed to identify the risk factors for this complication. Methods From 2009 to 2018, 425 patients were admitted with Neer type II clavicular fractures. According to the selection criteria, 352 patients were included in this retrospective observational study. All patients were divided into either the complications group (patients with midshaft fractures) or the control group (patients without midshaft fractures). Data collected included patient demographics and surgical, hook plate, and screw characteristics. The chi-square test was used to conduct between-group comparisons of risk factors. Statistically significant variables were included in a logistic regression model. Results In both the complications group (n = 21) and control group (n = 331), significantly more patients of advanced age and significantly more patients treated with hook plates that were not bent during surgery developed midshaft fractures. Conclusion The risk of a clavicular midshaft fracture after hook plate fixation may be significantly increased by advanced age or a lack of hook plate bending.
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Jeong, S.-M., D.-H. Suh, J.-H. Park, and J.-G. Moon. "RELATIONSHIP OF THE TRICEPS TENDON AND OLECRANON PLATES: AN ANATOMIC STUDY." Orthopaedic Proceedings 105-B, SUPP_8 (2023): 139. http://dx.doi.org/10.1302/1358-992x.2023.8.139.
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Olecranon plates used for the internal fixation of complex olecranon fractures are applied directly over the triceps tendon on the posterior aspect of the olecranon. The aim of the study is to describe the relationship of the plates and screws to the triceps tendon at the level of the olecranon.Eight cadaveric elbows were used. Dimensions of the triceps tendon at the insertion and 1cm proximal were measured. A long or a short olecranon plate was then applied over the olecranon and the most proximal screw applied. The length of the plate impinging on the tendon and the level of the screw tract on the tendon and bone were measured.The mean olecranon height was 24.3cm (22.4-26.9cm) with a tip-to-tendon distance of 14.5cm (11.9-16.2cm). The triceps tendon footprint averaged 13.3cm (11.7-14.9cm) and 8.8cm (7.6-10.2cm) in width and length, respectively. The mean width of the central tendon 1 cm proximal to the footprint was 6.8 cm. The long olecranon plate overlay over more movable tendon length than did the short plate and consequently the superior screw pierced the triceps tendon more proximally with the long plate. Using the Mann-Whitney U test, the differences were significant.The long olecranon plates encroach on more triceps tendon than short plates. This may be an important consideration for olecranon fractures with regards implant loosening or triceps tendon injury.
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Phadnis, Joideep, and Adam C. Watts. "Tension band suture fixation for olecranon fractures." Shoulder & Elbow 9, no. 4 (2017): 299–303. http://dx.doi.org/10.1177/1758573216687305.
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Olecranon fractures are common and often require surgical treatment when displaced. Traditional methods of stabilization using tension band wire fixation and plate fixation achieve adequate union and function but are associated with a high rate of re-operation and wound problems because of prominent metalwork. The purpose of the present article is to describe an all suture technique for fixation of simple olecranon fractures that maintains inter-fragmentary compression, provides bony union and reduces the rate of re-operation caused by prominent metalwork.
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Tie, Joyce, Michael K. H. Hsieh, and Shian Chao Tay. "Outcome of Hook Plate Fixation of Mallet Fractures." Journal of Hand Surgery (Asian-Pacific Volume) 22, no. 04 (2017): 416–22. http://dx.doi.org/10.1142/s0218810417500435.
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Background: Hook plate fixation of closed mallet fractures was first described in 2007, but there has subsequently been a lack of studies examining the outcomes and complications of this technique. Methods: This paper aims to assess the clinical outcomes of hook plate fixation of closed mallet fractures by retrospectively reviewing 31 closed, bony mallet injuries that were surgically fixed with a hook plate between 2002-2011. Results: Patients who underwent hook plate fixation had a median time to radiographic union of 83 days. Pre-operative median distal interphalangeal joint (DIPJ) extensor lag was 20°, with a post-operative extensor lag of 0°. Median DIPJ flexion was 60°, with 58% of all cases achieving greater than 50° of DIPJ flexion. There were 4 instances of minor complications (i.e. transient nail deformity and marginal skin flap ischaemia), with 3 cases of major complications (i.e. fracture redisplacement). Conclusions: Our results show that the hook plate technique has satisfactory functional outcomes and an acceptable complications rate compared to other treatment modalities in the existing literature. Nevertheless, the outcomes of this technique in our sample population were not as excellent as initially reported. Level of Evidence: Level IV: Retrospective case series, Therapeutic Studies
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Adams, Julie E., S. Andrew Sems, and Scott P. Steinmann. "Open Treatment of Olecranon Fractures with Plate Fixation." JBJS Essential Surgical Techniques 8, no. 1 (2018): e1. http://dx.doi.org/10.2106/jbjs.st.15.00012.
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Upendra, Kumar, Kumar Tiwari Shiwendu, Golwara Barun, and Rajak Rajeev. "Evaluation of Functional Outcome of Pre-Contoured Olecranon Locking Plate in Fractures of the Olecranon." International Journal of Pharmaceutical and Clinical Research 15, no. 8 (2023): 448–56. https://doi.org/10.5281/zenodo.11482206.
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<strong>Background:</strong> ‘Pre-contoured Olecranon Locking Plate’ provides rigid internal fixation allowing vigorous early mobilization at the elbow, especially in comminuted fractures of the olecranon. It shows an excellent rate of radiological union. Present study aims to evaluate the functional outcome of precontoured olecranon locking plate for fractures of the olecranon. <strong>Methods:</strong> This prospective study was done at Orthopedic emergency and the Out-Patient Department of Govt. Medical College and Hospital, Bettiah, Bihar from February 2019 to January 2020. The study was performed on thirty one skeletally mature patients with displaced fractures of the olecranon. Open reduction and internal fixation of displaced olecranon fracture of ulna with pre contoured olecranon locking plate. Patients were assessed by measuring the range of motion and Mayo Elbow Performance Score (MEPS) and index (MEPI). Serial radiographs were reviewed preoperatively for fracture classification and associated fractures, immediately postoperatively, and at the time of final review for adequacy and maintenance of reduction, evidence of union and arthritis. <strong>Results:</strong> At 1 year of follow up the mean flexion of elbow was 123.7<sup>0</sup> (range 90-130<sup>0</sup>), while the mean extension was 5.64<sup>0</sup> (range 0-30<sup>0</sup>). The MEPS index showed 1 patient having fair result, 6 patients having good results and 24 patients having excellent results. None of the patients had poor results. The mean MEPS were 90.65. All patients showed full radiological union. <strong>Conclusions:</strong> Pre-contoured olecranon locking plate to be more effective with a lower rate of symptomatic hardware and subsequent implant removal than tension band wiring.
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Lee, Seung-Jin, Tae-Won Eom, and Yoon-Suk Hyun. "Complications and Frequency of Surgical Treatment with AO-Type Hook Plate in Shoulder Trauma: A Retrospective Study." Journal of Clinical Medicine 11, no. 4 (2022): 1026. http://dx.doi.org/10.3390/jcm11041026.
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We investigated the complications and frequency of hook plate fixation in patients with shoulder trauma. We reviewed 216 cases of hook plate fixation use at our hospital between January 2010 and May 2020. Finally, we included 76 cases of acute distal clavicle fracture (DCF) and 84 cases of acute acromioclavicular joint dislocation (ACD). We investigated all complications after hook plate use, bony union in the DCF group, and reduction loss in the ACD group. We defined painful shoulder stiffness (PSS) as aggravating resting pain with stiff shoulder, and pain on shoulder elevation (PSE) as continued shoulder pain on elevation without PSS before plate removal. PSS was managed with intra-articular steroid injections or manipulation with or without arthroscopic capsular release (ACR). PSS occurred in 36 and 33 cases of DCF and ACD, respectively. PSE occurred in 17 of 76 fractures and 13 of 84 dislocations. However, no iatrogenic rotator cuff injury was verified by magnetic resonance imaging in patients with PSS or PSE. Subacromial erosion in patients with hook plate fixation should be considered a sequela and not a complication because it is unavoidable in surgery with an AO-type hook plate. The most common complication was PSS, followed by PSE.
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Singh, Manpreet. "An Assessment of 3.5mm Reconstruction Plate Fixation in Olecranon Fractures." Annals of International Medical and Dental Research 8, no. 1 (2022): 261–67. http://dx.doi.org/10.53339/aimdr.2022.8.1.34.
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Background: Olecranon process is a large, curved eminence comprising of the proximal and posterior part of the ulna. It lies subcutaneously which makes it more vulnerable to injury. Due to intra-articular extension of fractures, anatomical reduction and early mobilization should be achieved in every case and usually managed surgically. Aims and Objectives: To access the results of reconstruction plate in fracture olecranon.Materials &Methods: This was a prospective study consisted of 25 cases of olecranon fractures which were managed by open reduction and internal fixation using 3.5mm reconstruction plate. Patients were followed up every month till 6 months. At each follow up visit clinical and radiological parameters were assessed: Final assessment was done at 6 months using the Mayo Elbow Performance Score.Result: According to the AO classification, Type A-1 – 7 cases, A-3 – 1case, B-1 – 13 cases, B-3 – 1 case, C-1 – 1 case, C-2 – 1 case, C-3 – 1 case. An adequate reduction was maintained in all fractured olecranon until union. Average radiological union time was 12 weeks in 72% cases, 15 weeks in 16% cases, 18 weeks in 8% cases and > 18 weeks in 4% cases. The results were graded as per the criteria laid by Rogers et al as excellent in 84% cases, good in 12% and unsatisfactory in 4% cases. 2 cases developed superficial infection and 1 deep infection and 1 delayed union.Conclusion: Open reduction and internal fixation of fracture of olecranon with 3.5mm reconstruction plate is based on sound biomechanical principle with a good functional outcome and a low incidence of complications.
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Bosman, Willem-Maarten P. F., Benjamin L. Emmink, Abhiram R. Bhashyam, R. Marijn Houwert, and Jort Keizer. "Intramedullary screw fixation for simple displaced olecranon fractures." European Journal of Trauma and Emergency Surgery 46, no. 1 (2019): 83–89. http://dx.doi.org/10.1007/s00068-019-01114-4.
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Abstract Purpose Olecranon fractures are common and typically require surgical fixation due to displacement generated by the pull of the triceps muscle. The most common techniques for repairing olecranon fractures are tension-band wiring or plate fixation, but these methods are associated with high rates of implant-related soft-tissue irritation. Another treatment option is fixation with an intramedullary screw, but less is known about surgical results using this strategy. Thus, the purpose of this study was to report the clinical and functional outcomes of olecranon fractures treated with an intramedullary cannulated screw. Methods We identified 15 patients (average age at index procedure 44 years, range 16–83) with a Mayo type I or IIA olecranon fracture who were treated with an intramedullary cannulated screw at a single level 2 trauma center between 2012 and 2017. The medical record was reviewed to assess radiographic union, postoperative range of motion and complications (including hardware removal). Patient-reported outcome was evaluated using the Disabilities of the Arm, Shoulder and Hand (DASH) score. Average follow-up was 22 months (range 8–36 months). Results By the 6th month post-operative visit, 14 patients had complete union of their fracture and 1 patient had an asymptomatic non-union that did not require further intervention. Average flexion was 145° (range 135–160) and the average extension lag was 11° (range 0–30). Implants were removed in 5 patients due to soft-tissue irritation. Average DASH score (± standard deviation) by final follow-up was 16 ± 10. Conclusions Fixation of simple olecranon fractures with an intramedullary screw is a safe and easy fixation method in young patients, leading to good functional and radiological results. Compared to available data, less hardware removal is necessary than with tension-band wiring or plate fixation.
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Mukasa, Fumihiro, Yoshimasa Tomita, Hideyuki Hirasawa, and Kazuo Kaneko. "Hook Plate Technique for Bony Mallet Thumb." Case Reports in Orthopedics 2019 (November 4, 2019): 1–4. http://dx.doi.org/10.1155/2019/3538405.
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Bony mallet is a common sport injury, but bony mallet thumb is rarely encountered. We performed open reduction and fixation of bony mallet thumb using a hook plate procedure on a 27-year-old man under general anesthesia. The patient began working one day after surgery. Six months postoperatively, the patient had excellent dexterity according to Crawford’s evaluation criteria and no difficulties at work or playing softball. Tension band fixation, compression pins, and the extension block technique are commonly used to manage bony mallet. Despite the anatomical reduction, rigid fixation, and early resumption of motion skills offered by the hook plate technique, to our knowledge, no previous reports of its application to bony mallet thumb were found. In this case, the hook plate technique was chosen and made an early return to work possible and brought about a successful result.
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Seo, Joong-Bae, Seong-Jun Kim, Hee-Jung Ham, and Jae-Sung Yoo. "Comparison between hook plate fixation with and without coracoclavicular ligament suture for acute acromioclavicular joint dislocations." Journal of Orthopaedic Surgery 28, no. 1 (2020): 230949902090505. http://dx.doi.org/10.1177/2309499020905058.
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Background: Hook plates are widely used for repair of acromioclavicular joint (ACJ) dislocations. However, it is unclear whether repair of torn coracoclavicular (CC) ligament is necessary. The purpose of this study was to evaluate the outcomes of the hook plate fixation with direct CC ligament repair for acute ACJ dislocation in comparison with the hook plate fixation without direct CC ligament repair. Methods: The study included 120 patients with acute ACJ dislocations who underwent surgery. The patients were divided into 73 patient groups with Arbeitsgemeinschaft für Osteosynthesefragen (AO) hook plate fixation and direct CC ligament repair and 47 patient groups without direct CC ligament repair. For clinical assessments, the American Shoulder and Elbow Surgeons score, constant score, and time for implant removal were recorded. The corcoclavicular distance (CCD) and the CCD ratio were used for the evaluation of reduction. Typical reported complications, such as secondary dislocation, implant failure or loosening, peri-implant fracture, acromion osteolysis, and postoperative ACJ arthrosis, were also analyzed. Results: There were no differences in the clinical outcomes between the two groups. There was no difference in the timing of implant removal between the two groups. The last follow-up CCD was not statistically significant between group with direct CC ligament repair and without repair (9.1 ± 3.3 vs. 9.0 ± 2.8, respectively, p > 0.05). The last follow-up CCD ratio showed significant differences between the two groups (12.6 ± 25.5% vs. 26.3 ± 39.7, respectively, p < 0.05). There was no statistically significant difference in the complication rate between the two groups. Conclusion: The hook plate fixation with direct CC ligament repair group was better for maintenance of reduction than that of the hook plate fixation without direct CC ligament repair group. Although, there were no differences of clinical outcomes and complications between two groups. Level of Evidence: Level III, Retrospective Study.
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Vajapey, Sravya, Darren R. Plummer, Juan E. Santiago, and Ryan K. Harrison. "Hook Plate Fixation of Medial Malleolar Fractures." Techniques in Orthopaedics 35, no. 4 (2018): 272–75. http://dx.doi.org/10.1097/bto.0000000000000354.
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Kumar, Dr Thiripan Sathish, Dr Anantharaman MS, and Dr Karthikeyan. "The outcome of plate fixation for displaced olecranon fractures." International Journal of Orthopaedics Sciences 6, no. 1 (2020): 391–93. http://dx.doi.org/10.22271/ortho.2020.v6.i1g.2189.
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Duckworth, Andrew D., Nicholas D. Clement, Timothy O. White, Charles M. Court-Brown, and Margaret M. McQueen. "Plate Versus Tension-Band Wire Fixation for Olecranon Fractures." Journal of Bone and Joint Surgery 99, no. 15 (2017): 1261–73. http://dx.doi.org/10.2106/jbjs.16.00773.
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Al. O., Şerban, and Obadâ B. "Locking or Non-locking Hook Plate in Treatment of Unstable Lateral Clavicle Fracture." ARS Medica Tomitana 20, no. 3 (2015): 150–52. http://dx.doi.org/10.2478/arsm-2014-0027.
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Abstract The purpose of this study was to compare the outcomes and complications of locking or nonlocking clavicular hook plate for fixation of unstable lateral clavicle fractures. All patients with unstable Neer type II lateral clavicle fractures were operated in our hospital from January 2011 to December 2012. The included participants received either locking or nonlocking clavicular hook plate operations. Demographic data, medical records and radiographs were reviewed retrospectively. At the last follow-up, shoulder function was evaluated with Constant-Murley scoring system. Our findings suggest that locking clavicular hook plates are equally useful for treating unstable lateral clavicular fractures, but in face of complicated ones, the locking hook plate would not get more benefits than nonlocking hook plate.
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Elshahhat, Amr, and Moheib Sayed Ahmed. "Dual fixation for coracoid fracture with acute acromioclavicular joint disruption: A case series." Hong Kong Journal of Orthopaedic Research 5, no. 3 (2022): 32–37. http://dx.doi.org/10.37515/ortho.8231.5301.
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Introduction: Management of concomitant coracoid fracture with acute acromioclavicular joint disruption has been a matter of debate. The coracoid component is not always radiographically recognized; thus, this combined orthopedic injury is not often common. Management options varied from conservative to surgical management with single or dual fixation strategy. This study aimed at outcome evaluation of clavicular hook plate with coracoid screw fixation in athletics and patients with high-demand activities for at least one year follow-up. Material and methods: Included patients underwent fixation through clavicular hook plate and coracoid screw. The hook plate was removed after an average period of 16.1 weeks, rehabilitation program was followed. Patients were subjected at final follow-up visit to clinical assessment via ROMs, constant, and ASES scores. Besides, radiological judgement of acromioclavicular joint reduction as per CCD and CCD ratio. Results: The average ASES Scores were 39.1±14.6, 67.4±11.5, and 86.7±5.7 at 3, 6, and 12 months, respectively with a statistically significant improvement in between (P-value <0.001). The mean active shoulder abduction and forward elevation ROMs were 156.4°±12.8° and 171.4°±6.3°. The average CCD was 9.04±0.9 mm (7.6-10.2 mm), and the mean CCD ratio was 1.07±0.03% (1.01-1.11%). Conclusion: Dual fixation via hook plate and coracoid screw without CCL reconstruction provides a stable fixation construct with considerable functional and radiological outcome in high demand patients with acute traumatic ACJ disruption combined with coracoid fracture. Study Design: Case series study.
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Inam, Muhammad, Wajid Rehan, Muhammad Kamran Shafi, et al. "Outcome of Olecranon Fracture Treated with Tension Band Wiring Versus Anatomical Locking Plate Fixation." Pakistan Journal of Medical and Health Sciences 17, no. 11 (2024): 51–55. http://dx.doi.org/10.53350/pjmhs02023171151.
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Aim: Up to 10% of all upper limb fractures involve the olecranon, and this type of fracture is the most common osseous injury of the elbow joint. These show a bimodal distribution occurring in younger patients due to high-energy trauma and in elderly cohorts with low bone quality after low-energy falls. Objective: To compare functional outcome of tension band wiring versus anatomical locking plate fixation for reduction of olecranon fracture Materials and Methods: This randomized controlled trial study was conducted in the Department of Orthopedic, Lady Reading Hospital, Medical Teaching Institute Peshawar from December 2022 to June 2023. Non-probability consecutive sampling technique was used in this study. Sample size was calculated using WHO calculator keeping 95% confidence interval 80 % power of study, 10% absolute precision, mean Mayo elbow score was 84.0±9.3 in the TBW group and 88.3±9.1 in the locking plate fixation group (4). Expected sample size is 32 patients in each group, total 72 patients. Patients of both genders have age range from 20 to 70 year with Mayo type 2A olecranon fractures, more than 2 mm of joint displacement determined on X-ray elbow, and elbow extension loss determined on physical examination presented within 7 days of the injury were included in the study while Patients with open fracture and revision surgery were excluded from the study. Results: In this study age distribution among 72 patients was analyzed as n= 20-30 Years 17(27.4%) 31-40 Years 14(22.6%) 41-50.Years 11(17.7%) 51-70 Years 20(32.3%). Mean age was 47.1 Years with SD ± 2.87. Gender wise Distribution among 72 Patients was analyzed as Male were 31(50.0%) and female were 31(50.0%). Distribution of duration of disease among 72 patients were analysed as n= 1-2 weeks were 47(75.8%) and 3-4 weeks were 15(24.2%) Practical Implication: There are no established guidelines for the treatment of olecranon fracture in our institution. Most olecranon fractures are treated according to surgeon preferences and surgical experience of the surgeon. Previous studies showed variables results with no consensus. We will provide rationale basis for universal use of standard treatment of olecranon fracture. Conclusion: Although there were no statistically significant differences in clinical outcomes between the two groups, the ALP group had a higher proportion of any complication than the RP group. Keywords: Anatomical locking plate; complications; eyelet wire; olecranon fracture; tension band wiring.
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Saya, Venkateswara Prasad, Maheswara Reddy Battu, Muddamsetti Nagesh, and G. Raghava Naidu Y. "Postoperative Results in Patients Undergoing Treatment of Fractures of the Lateral End Clavicle by Hook Plate." International Journal of Pharmaceutical and Clinical Research 16, no. 12 (2024): 610–14. https://doi.org/10.5281/zenodo.14590245.
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<strong>Background: </strong>Fracture lateral ends of clavicle were vulnerable for instability and remain a challenge for the orthopedic surgeons. The clinical result of fracture fixation of lateral end clavicle using hook plate was described and practiced by any surgeons and seemed to be well accepted by others in terms of fracture union and function. The principal advantages were anatomical reduction of the fracture and early rehabilitation which lead to good shoulder girdle function. <strong>Aim of the Study: </strong>The aim of this study is to evaluate the functional outcomes of clavicle hook plate fixation for fractures of the lateral clavicle and acromio-clavicular joint disruption; to evaluate the outcomes of managing unstable fractures of the lateral end of the clavicle using a clavicle hook plate. <strong>Materials: </strong>This study included 31 patients with displaced fractures of the lateral end of the clavicle, all treated with clavicle hook plate fixation. The mean age of the patients was 29.55±3.5 years, with a range from 18 to 55 years. <strong>Results: </strong>The mean follow-up period was 18 months, with a range of 12 to 20 months. The average fracture healing time was 10.25±1.35 weeks post-operatively. One patient (03.22%) experienced nonunion but had good alignment and remained asymptomatic without functional disability. Another patient (03.22%) developed a superficial wound infection, while a third (03.22%) had impingement, which resolved after plate removal. Additionally, one patient (03.22%) developed acromio-clavicular (AC) joint arthrosis. The mean Constant score for the affected shoulder was 87.95±2.50 points (range, 85–100), while the score for the contralateral shoulder averaged 92.65±20 points (range, 92–100). Plate removal was performed in only three patients-(09.67%). <strong>Conclusion: </strong>The clavicle hook plate is an effective method for managing lateral end clavicle fractures, providing stable fixation with a low complication rate. Plate removal is not necessary in most cases.
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Cutter, Brenden, Shayne R. Kelly, Charles R. Beckett, and Eric G. Huish. "The biomechanical strength of olecranon fixation constructs: a systematic review and meta-regression." International Journal of Research in Orthopaedics 8, no. 2 (2022): 240. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20220614.
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<p class="abstract">Olecranon fractures are often operative when displaced over 2 mm, but the most stable fixation construct is debated. The purpose of this study was to provide an overview of biomechanical properties of the most commonly used surgical fixations of olecranon fractures. This systematic review included 13 biomechanical studies comparing displacement during cyclic loading of olecranon fractures fixated with either tension band wiring (TBW), intramedullary screw, or plate fixation. In regard to overall gapping, plates displayed (and screws trended towards) increased stability versus TBW. However, there was no difference between the constructs in gapping at the articular surface. Plating displayed increased stability along the posterior surface. No construct allowed gapping over 2 mm, suggesting safe early post-operative motion with any of the techniques.</p>
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Panchbhavi, Vinod K., Milan G. Mody, and William T. Mason. "Combination of Hook Plate and Tibial Pro-Fibular Screw Fixation of Osteoporotic Fractures: A Clinical Evaluation of Operative Strategy." Foot & Ankle International 26, no. 7 (2005): 510–15. http://dx.doi.org/10.1177/107110070502600702.
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Background: Internal fixation of osteoporotic ankle fractures is technically difficult and may fail because of unreliable purchase. This study was undertaken to determine if a combination of a hook plate and tibial pro-fibular screws can provide secure fixation until fracture union. Methods: Thirty-one patients between the ages of 55 and 90 years had open reduction and internal fixation of ankle fractures between April, 2001, and April, 2003. Sixteen patients with an average age of 71.4 years had ankle fracture fixation with a combination of hook plate and tibial pro-fibular screws for the distal fibular fracture, and 15 patients with an average age of 71.9 years had fixation of their ankle fractures with standard fixation technique using AO/ASIF principles but no tibial pro-fibular screws. All patients were followed with clinical and radiologic assessment at 2 weeks, 6 weeks, and 12 weeks postoperatively. At an average of 15.8 months after injury, patients also completed a mailed questionnaire with the Olerud-Molander ankle score and the AOFAS ankle-hindfoot score for preoperative and postoperative status. Results: All patients who had tibial pro-fibular screw fixation had fracture union without hardware failure or complications. In the standard fixation group two patients had wound breakdown and one had a valgus malunion with screw pull out. The AOFAS and Olerud-Molander scores for the standard open reduction and internal fixation were 57.3 and 82.8 before injury and 37 and 43.8 postoperatively, respectively. The AOFAS and Olerud-Molander scores for the hook plate and tibial pro-fibular fixation group were 55.9 and 81.3 before injury and 42.4 and 50.3 postoperatively, respectively. Conclusions: The combination of hook plate and tibial pro-fibular screws in osteoporotic ankle fractures in a series of patients has not been reported before. This novel technique provides stable fixation for osteoporotic ankle fractures in elderly patients until union is achieved with good clinical scores.
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Eskandar, Mohammad, Maen Saed, and Safwan Yusuf. "Functional outcomes of tension band wiring versus hook plating in displaced, closed, and isolated distal clavicle fractures in adults: a comparative retrospective study." Annals of Medicine & Surgery 86, no. 11 (2024): 6409–15. http://dx.doi.org/10.1097/ms9.0000000000002475.
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Introduction: Clavicle fractures are common among young people, generally as a consequence of car accidents, bike falls, and contact sports injuries. 15–20% of all clavicle fractures involve the lateral end of the bone. Thus, the distal clavicle fractures, in particular, have a high non-union rate ranging from 21 to 33% when treated non-operatively, underscoring the usual advice for operative treatment. While significant research has been conducted on clavicle fractures and their treatment options, no definitive guidelines or optimal approaches have been established. Hence, the aim of this study was to assess the clinical and radiological results of the two highly used surgical techniques, Tension Band Wiring (TBW) and Hook plate ones, in addition to investigating the associated functional recovery and outcomes. Methods: Between August 2019 and 2022, An analytical retrospective comparative study, was done on 38 patients (20 TBW and 18 Hook plate) diagnosed with unstable fracture of the lateral third of clavicle (Neer 2), aged between 18 and 65 years old, and followed up for more than 12 months. Results: TBW technique was used in 20 patients (14 males and 6 females) with mean age 39.25 years and Hook plate was used in 18 patients (14 males,4 females) with mean age of 43.11 years. The union rate was 100% in Hook plate group and 95% in TBW group. The mean time of bony union to occur was (9.55) weeks in TBW group and (8.94) weeks in Hook plate group. The mean of constant–Murley score in the last follow-up was 85.32 in the TBW group and 87.38 in the Hook plate group. superficial infection occurred in 3 cases in TBW group (15%). Four patients complained of impingement, three patients complained of acromial erosion and one patient complained of acromial osteolysis in the Hook plate group. Conclusion: Both TBW and Hook plate are a good choice for the fixation of displaced distal clavicle fractures with good functional and radiological outcomes, where Hook plate have some advantages such as rigid fixation and early motion of the affected shoulder.
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Milner, Chris, Deepak Samson, and Simon Tan. "Unstable Dorsal Fracture-Dislocations of the Proximal Interphalangeal Joint: Volar Plate Fixation with or without Bone Graft." Journal of Hand Surgery (Asian-Pacific Volume) 24, no. 01 (2019): 50–54. http://dx.doi.org/10.1142/s2424835519500097.
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Background: To evaluate the treatment of severe dorsal fracture dislocation (DFD) injuries of the proximal interphalangeal joint (PIPJ) by open reduction, bone grafting and fixation with mini-hook plates. Methods: Fourteen patients with extensive dorsal fracture dislocation of the PIPJ were operatively treated to reconstruct the fractured middle phalanx volar lip using a fabricated hook plate in conjunction with elevation and bone grafting of depressed articular fragments where present. Results: Restoration of PIPJ articular anatomy and congruence by hook plate fixation permitted full-range mobilization of the joint during fracture healing, with an average arc of motion of 81° and an average loss of extension of 12.9° at a minimum of 6 months follow up. Hook plate treatment of PIPJ fracture dislocation restores articular anatomy and joint congruence at a single sitting and permits post-operative mobilization without the need for extension block splinting. Conclusions: Our results demonstrate a good range of motion following treatment, however hardware removal and tenolysis was necessary in 36% of cases.
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Rush, Kaitlin, John Fisher, Neil Jain, Caleb Gottlich, and Cyrus Caroom. "Fixation of Olecranon Fractures Using a Hybrid Intramedullary Screw and Tension Band Construct." Advances in Orthopedics 2024 (May 30, 2024): 1–6. http://dx.doi.org/10.1155/2024/6471544.
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Introduction. Olecranon fractures are common injuries that require surgical intervention for optimal outcomes. Various fixation methods have been described in the literature, including the use of intramedullary proximal ulna screws in combination with tension band augmentation. Limited research has compared this hybrid technique to other established methods of fixation. This study compared complication and reoperation rates between multiple groups. Methods. A retrospective review was conducted on patients with olecranon fractures who underwent internal fixation at a level 1 trauma center between January 1st, 2013, and April 22nd, 2023. Data was collected using CPT codes, and patients were categorized into five groups based on the method of fixation received: no implant, tension band only, locking olecranon plate, intramedullary screw and tension band hybrid, and others. Variables such as patient demographics, Mayo fracture classification, open vs. closed injury, implant type, reoperation rates, and postoperative complications were recorded. Results. A total of 217 patients were included in the study. No difference was found with implant choice and reoperation rate (p=0.461). There was a significant difference found with reoperation and fracture type (p=0.027) and open fracture (p=0.002). Conclusion. The primary findings of this study indicate no significant difference in implant choice and reoperation rates among the various fixation methods used for olecranon fractures. These findings suggest that the hybrid fixation technique, utilizing intramedullary proximal ulna screws in combination with tension band augmentation, is a viable and comparable treatment option when evaluated against other well-documented methods of fixation. This study also reiterates that severity of initial injury is often the most important factor related to poorer outcomes. Further discussion and analysis of the data will provide a comprehensive understanding of implications and recommendations for olecranon fracture fixation.
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Yoon, Byungil, Jae Yoon Kim, Jae Sung Lee, and Hyoung Seok Jung. "The Radiologic Comparison of Operative Treatment Using a Hook Plate versus a Distal Clavicle Locking Plate of Distal Clavicle Fracture." Clinics in Shoulder and Elbow 21, no. 4 (2018): 227–33. http://dx.doi.org/10.5397/cise.2018.21.4.227.
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BACKGROUND: The purpose of this study was to compare the radiologic results of patients who underwent surgery with a hook plate and a locking plate in distal clavicle fractures.METHODS: Sixty patients underwent surgical treatment for Neer type IIa, IIb, III, and V distal clavicle fracture. Twenty-eight patients underwent fracture fixation with a hook plate and 32 with a locking plate. Coracoclavicular distance was measured on standard anteroposterior radiographs before and after the surgery, and union was confirmed by radiograph or computed tomography taken at 6 months postoperatively. Other radiologic complications like osteolysis was also checked.RESULTS: Bony union was confirmed in 59 patients out of 60 patients, and 1 patient in the hook plate group showed delayed union. Coracoclavicular distance was decreased more in the hook plate group after surgery (p < 0.01). After 6 weeks of the hook plate removal, the coracoclavicular distance was increased a little compared to before metal removal, but there was no difference compared to the contralateral shoulder. Eleven out of 28 patients (39.3%) showed osteolysis on the acromial undersurface in the hook plate group.CONCLUSIONS: Both the hook plate group and the locking plate group showed satisfactory radiologic results in distal clavicle fractures. Both hook plate and locking plate could be a good treatment option if it is used in proper indication in distal clavicle fracture with acromioclavicular subluxation or dislocation.
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Buryanov, Olexander, Volodymyr Kvasha, Dmytro Chekushyn, Mykhailo Zadnychenko, Mykhailo Karpinsky, and Olexander Yaresko. "STRESS-DEFORMED STATE OF THE ACROMIOCLAVICULAR JOINT IN CASE OF DAMAGE TO THE UPPER ACROMIOCLAVICULAR LIGAMENT SUPERIOR AND VARIOUS METHODS OF FIXATION." ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, no. 2 (July 9, 2024): 33–41. http://dx.doi.org/10.15674/0030-59872024233-41.
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During the operative stabilization of the acromial end of the clavicle (AEC) for its dislocation, there are two ways: clavicle – beaklike process, clavicle – acromial process. Fixation of the AEC to the acromial process of the scapula is a priority. Competing metal structures are the hook plate and the Weber method. The significant disadvantages of using the Weber method of fixation are the migration of the tips and the violation of their integrity andthe wire. Objective. To conduct a comparative analysis of the fixation of the acromial end of the clavicle according to Weber, hook plate and the proposed construction, by studying the stressed-deformed state of the clavicular-acromial joint in case of damage to the lig. acromioclavicular superior and various methods of fixation. Methods. A finite-element model of the clavicular-acromial joint was constructed. Damage to the ligaments was modeled. claviculo-acoacromiale superior, as well as fixation of AEC in three ways: according to Weber, hook plate and the proposed construction. Results. The best results, from the point of view of reducing the level of stresses in intact ligaments, are provided by fixation of the AEC according to Weber, but its use leadsto an increase in the level of stresses on the AEC and the acromial process of the scapula, which can cause destruction of the latter. The hinge-type fixator provides the best stress distribution, both in the bony elements of the model and in intact ligaments. The hook plate holder occupies an average position,both in terms of the level of stress and the magnitude of the relative deformations in the ligaments. Conclusions. Weber fixation provides the best results for reducing the level of stresses and relative strains in the intact ligaments, but leads to a several-fold increase in the level of stresses on the AEC and acromial process of the scapula. The hook plate holder occupies an average position, both in terms of the stress level and the magnitude of the relativedeformations in the ligaments. The proposed design provides the best stress distribution, both in the bony elements of the model and in the intact ligaments.
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Maljkovic, Filip, Aleksandar Stanojkovic, Boris Zekic, Filip Milanovic, and Branislav Krivokapic. "Monteggia fracture associated with olecranon fracture-dislocation mayo IIIB." Srpski arhiv za celokupno lekarstvo, no. 00 (2025): 38. https://doi.org/10.2298/sarh241116038m.
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Introduction. Monteggia fractures involving olecranon fracture-dislocations present complex challenges due to the need for simultaneous stabilization of multiple joint components. These injuries require precise surgical planning and execution to restore elbow function and minimize complications such as joint instability, nonunion, and reduced mobility. Modern surgical techniques, including the use of locking plates and careful anatomical reduction, have shown to significantly improve long-term outcomes. Case outline. This case report discusses the management of a 30-year-old female patient with a Monteggia fracture and olecranon fracture-dislocation following a cycling accident. The patient underwent delayed surgery due to severe soft tissue injuries. The procedure involved ulna fixation with an olecranon plate and radial head stabilization using a fiber tape system. Despite incomplete rehabilitation, the patient showed satisfactory recovery with only minor limitations in elbow movement. This case emphasizes the importance of early intervention, precise reduction, and the use of modern fixation techniques in optimizing recovery for complex elbow injuries. Conclusions. Effective treatment of Monteggia fractures associated with olecranon dislocation requires early intervention, precise anatomical reduction, and the use of modern fixation techniques to ensure optimal functional outcomes and minimize long-term complications.
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Panthi, Sagar, Rishiswor Shrestha, Sabal Krishna Gaihre, Angelica Karki, and Suyachha Chettri. "Neer Type II Distal End Clavicular Fracture: Outcome with Clavicular Hook Plate Fixation." Europasian Journal of Medical Sciences 2, no. 2 (2020): 1–4. http://dx.doi.org/10.46405/ejms.v2i2.195.
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Background: Distal end clavicular fractures are rare type of injuries seen in adult population. These fractures are unstable because of various deforming forces. Clavicular hook plate aligns the clavicle along with ligaments. The aim of this study is to observe the outcome of displaced distal end clavicular fracture managed with hook plate fixation.Methods: Twenty five patients with displaced distal end clavicular fractures (Neer type II) were evaluated retrospectively from November 2018 to September 2020. Functional outcome were assessed via Constant and Murley score at one year final follow-up.Results: 60% of patient had excellent outcome, 32% of patient had good outcome and 8% of patient had fair outcome at final follow-up. Mean Constant and Murley score was 86. Four patients developed subacromial osteolysis which resolved at final follow-up. One patient had extra-articular ossification whereas none of the patient developed non-union and AC joint arthrosis.Conclusion: Clavicular hook plate provides stable fixation of distal end clavicular fracture with few complications and is cost-effective.Keywords: Clavicular Hook Plate; Complications; Distal End Clavicular Fractures; Subacromial Osteolysis