Our Results With Tension-Band-Wiring Technique In The Management Of Displaced Olecranon Fractures

OBJECTIVE: Displaced fractures of the olecranon are almost always managed surgically. The aim of this study was to retrospectively evaluate the results of patients with displaced olecranon fractures who had been operated with tension band wiring method and to understand the subjective complaints and factors influencing the overall functional outcomes. Twenty eight patients who had been operated at our clinic for displaced olecranon fractures between 2001-2005 with at least one year of follow up have been retrospectively evaluated. Eighteen of the patients were male and 10 were female. The mean age of the patients was 37 (range;16-58) and the mean follow up was 32 months (range; 13-62). Four patients had Gustillo-Anderson Type I and one patient had Gustillo-Anderson Type II open fracture. Schatzker-Schmeling morphological fracture classification was used. The patients were radiologically evaluated for the presence of any articular step off or any degenerative changes, and were clinically evaluated according to the Broberg - Morrey index scores; operated side elbow range of motions were compared with the contralateral extremity. All cases had a solid union of the fracture. Degenerative changes of the elbow joint at the varying degrees were observed in 10 (%36) of the patients and an average of 10° (range; 5-12) loss of elbow motion was observed in the study. According to the Broberg – Morrey classification, 21 patients (%75) had perfect or good, 6 patients (%21) had fair and one patient (%4) had poor result. The retrospective evaluation of the patients with fair and poor results showed that these fractures were high energy, unstable, comminuted fractures of whom postoperative rehabilitation program could not be started immediately. Modified tension band wiring method with good surgical technique in combination with early postoperative rehabilitation seemed to be effective on overall functional results of stable displaced olecranon fractures.
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Deplase Olekranon Kiriklarinda Germe Bandi Tekniği İle Sonuçlarimiz

AMAÇ: Deplase olekranon kırıkları, eklem içi kırıklardır ve tedavisi hemen her zaman cerrahidir. Bu çalışmanın amacı, kliniğimizde germe bandı tekniği ile opere edilen olekranon kırıklı hastaların sonuçlarını retrospektif inceleyerek hastaların subjektif şikayetlerini ve fonksiyonel sonuçlarını etkileyen faktörleri belirlemektir. 2001- 2005 tarihleri arasında kliniğimizde cerrahi olarak tedavi edilen ve en az 1 yıllık takibi bulunan 28 hasta çalışmaya dahil edildi. Hastaların 18’i erkek, 10’u kadın, ortalama yaş 37 (16-58), ortalama takip süresi 32 aydı (13-62). Gustillo-Anderson sınıflamasına göre 4 hastada Tip I, 1 hastada Tip II açık kırık vardı. Kırıklar Schatzker-Schmeling morfolojik sınıflamasına göre sınıflandırıldılar. Son kontrollerinde hastalar radyolojik olarak eklemde basamaklanma miktarı, dejeneratif değişikliklerin varlığı, fonksiyonel açıdan da Broberg ve Morrey indeks skoruna göre ve karşı dirsek hareketleri ile karşılaştırılarak değerlendirildiler. Hastaların tamamında ortalama 8 (6-10) haftada kaynama sağlandı. Hastaların 10’unda (%36) değişik düzeyde dejeneratif artrit bulguları, dirsek hareket açıklığında da karşı tarafa göre ortalama 10°’lik kayıp (5-12°) gözlendi. Broberg ve Morrey endeksine göre 21 hastada mükemmel ve iyi, 6 hastada orta ve 1 hastada kötü sonuç alındı. Stabil olekranon kırıklarında uygun cerrahi teknikle yapılmış modifiye germe bandı tekniği ve erken rehabilitasyonun, iyi sonuçlar üzerinde etkili olduğu bulundu.
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