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VOLUME 14 , ISSUE 3 ( September-December, 2019 ) > List of Articles


Intramedullary Cancellous Screw Fixation of Simple Olecranon Fractures

Colby Oitment, Alex Koziarz, Anthony Bozzo, Herman Johal

Keywords : Elbow, Fracture, Olecranon, Technique

Citation Information : Oitment C, Koziarz A, Bozzo A, Johal H. Intramedullary Cancellous Screw Fixation of Simple Olecranon Fractures. 2019; 14 (3):163-167.

DOI: 10.5005/jp-journals-10080-1435

License: CC BY-NC-SA 4.0

Published Online: 11-07-2020

Copyright Statement:  Copyright © 2019; The Author(s).


Olecranon fractures and osteotomies are treated with either tension-band wiring or plate-screw fixation; however, these methods of fixation have high rates of symptomatic hardware, resulting in revision surgery. We describe the novel use of intramedullary noncannulated long screws to gain rigid internal fixation and allow early range of motion. Our procedure differs from traditional intramedullary olecranon fixation as the longer screws, which can commonly be found on many pelvic fixation sets, allow for endosteal purchase at the isthmus of the ulna, which increases the pull-out strength of the screw. This procedure can be done quickly and requires minimal exposure, which minimises anaesthetic exposure, blood loss, and tourniquet time. The construct is not palpable subcutaneously and therefore is less likely to result in symptomatic hardware and revision surgery.

  1. Rommens PM, Kuchle R, Schneider RU, et al. Olecranon fractures in adults: factors influencing outcomes. Injury 2004;35(11):1149–1157. DOI: 10.1016/j.injury.2003.12.002.
  2. Hotchkiss RN. Fractures and dislocations of the elbow. In: Rockwood CA, Green DP, Bucholz RW, et al. Fractures in Adults. 4th ed., Lippincott-Raven, Philadelphia pp. 984–994.
  3. Duckworth AD, Clement ND, White TO, et al. Plate versus tension-band wire fixation for olecranon fractures: a prospective randomized trial. JBJS 2017;99(15):1261–1273. DOI: 10.2106/JBJS.16.00773.
  4. Ruedi TP, Buckley R. AO principles of fracture management. vol. 2 Specific fractures. New York: Thieme; 2007. pp 871–892.
  5. Veillette CJH, Steinmann SP. Olecranon fractures. Orthopedic Clinics of North America 2008;39(2):229–236. DOI: 10.1016/j.ocl.2008. 01.002.
  6. Hak DJ, Golladay GJ. Olecranon fractures: treatment options. J Am Acad Orthop Surg 2000;8(4):266–275. DOI: 10.5435/00124635-200007000-00007.
  7. Newman SD, Mauffrey C, Krikler S. Olecranon fractures. Injury 2009;40(6):575–581. DOI: 10.1016/j.injury.2008.12.013.
  8. Duckworth AD, Bugler KE, Clement ND, et al. Nonoperative management of displaced olecranon fractures in low-demand elderly patients. JBJS 2014;96(1):67–72. DOI: 10.2106/JBJS.L.01137.
  9. Harmon PH. Treatment of fractures of the olecranon by fixation with stainless-steel screws. JBJS 1945;27:328–329.
  10. Callahan JJ. Fractures involving the elbow. Surg Clin North Am 1947;27(1):213–215. DOI: 10.1016/s0039-6109(16)32046-1.
  11. Colton CL. Fractures of the olecranon in adults: Classification and management. Injury 1973;5(2):121–129. DOI: 10.1016/s0020-1383(73)80088-9.
  12. Rettig AC, Waugh TR, Evanski PM. Fracture of the olecranon: a problem of management. J Trauma 1979;19(1):23–28. DOI: 10.1097/00005373-197901000-00005.
  13. Raju SM, Gaddagi RA. Cancellous screw with tension band wiring for fractures of the olecranon. J Clin Diagn Res 2013;7:339.
  14. Grechenig W, Clement H, Pichler W, et al. The influence of lateral and anterior angulation of the proximal ulna on the treatment of a monteggia fracture: an anatomical cadaver study. J Bone Joint Surg Br 2007;89(6):836–838. DOI: 10.1302/0301-620X.89B6.18975.
  15. Rouleau DM, Faber KJ, Athwal GS. The proximal ulna dorsal angulation: a radiographic study. J Shoulder Elbow Surg 2010;19(1):26–30. DOI: 10.1016/j.jse.2009.07.005.
  16. Morrey BF, Sanchez-Sotelo J. The elbow and its disorders. 4th edn., Philadelphia: Saunders; 2009.
  17. Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. JBJS 1985;67(9):1396–1401. DOI: 10.2106/00004623-198567090-00015.
  18. Shakir I, Israel H, Cannada LK, et al. Biomechanical study of olecranon plate fixation in comminuted osteoporotic fracture model: locking compression plates versus dynamic compression plates. Curr Orthop Pract 2018;29:167–172. DOI: 10.1097/BCO.0000000000000602.
  19. den Hamer A, Heusinkveld M, Traa W, et al. Current techniques for management of transverse displaced olecranon fractures. Muscles Ligaments Tendons J 2015;5(2):129. DOI: 10.32098/mltj.02.2015.13.
  20. Johnson RP, Roetker A, Schwab JP. Olecranon fractures treated with AO screw and tension bands. Orthopedics 1986;9(1):66–68.
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