The application of central tension plate with sharp hook in the treatment of intra-articular olecranon fracture

BACKGROUND Standard plate fixation can be used to treat intraarticular olecranon fractures with satisfactory functional recovery, but its use is accompanied by implant related complications. This retrospective study reports on the functional outcome of intraarticular olecranon fractures treated with a central tension plate with sharp hook. METHODS A retrospective review of any patient with an olecranon fracture from August 2007 to December 2008 was conducted. Patients were considered for inclusion in the study if they were treated surgically with a central tension plate with sharp hook. Patients with pathological fractures or previous fractures of the proximal ulna were excluded. The quality of reduction was evaluated using postoperative imaging. The functional recoveries of the affected upper limbs were evaluated postoperatively at regular intervals using the Mayo Elbow Performance (MEP) score and Disability of the Arm, Shoulder and Hand questionnaire (DASH). RESULTS Twenty six patients met the study criteria and were included in analysis. There were ten Type IIA, nine Type IIB, four Type IIIA and three Type IIIB fractures according to the Mayo classification system. Thirteen patients exhibited other concomitant fractures at the time of surgery: one patient with a coronoid fracture, two with a fracture of the radial head, and ten with fractures in other bones. Postoperative radiographic assessment revealed an anatomical or nearly anatomical reduction of all olecranon fractures treated. All olecranon fractures healed at an average of 14 weeks (range, 9 to 32 weeks). The patients were followed up for 42 months (range, 32 to 54 months). The mean DASH score was 8.5 (range, 0 to 31.7). The mean MEP score was 93.6 (range, 75 to 100). Based on the MEP score, all patients achieved good or excellent outcomes. No symptomatic plate removal was performed at the time of last follow-up. CONCLUSION The central tension plate with sharp hook closely contours to the osteology of the proximal ulna. Treating intra-articular olecranon fracture with this new plate can achieve good to excellent functional outcome with a high union rate and a low incidence of hardware related complications.