Factors Associated with Reoperation after Fixation of Displaced Olecranon Fractures

Peters, R. (Rinne) (2015) Factors Associated with Reoperation after Fixation of Displaced Olecranon Fractures. thesis, Medicine.

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Abstract

Background Figure-of-eight tension band wiring (TBW) is often used to repair non-fragmented displaced fractures of the olecranon. High rates of second surgeries to remove the wires have led orthopaedic surgeons to consider alternatives, such as plate fixation or intramedullary screws or rods [1-3]. However, it is estimated that the total costs are still much lower for TBW, even when reoperation is performed. In addition, it is not clear whether plates and screws, which can also be prominent, cause fewer symptoms. Some surgeons believe that specific techniques of TBW can limit wire prominence and requests for a second surgery to remove the wires. This study aims to identify factors associated with reoperation and reoperation for implant removal. We hypothesized that there are no factors associated with reoperation after open reduction and internal fixation of a fracture of the olecranon. Methods Data was analyzed from 392 adult patients that underwent operative treatment of a displaced olecranon fracture, which was not associated with any other fractures, dislocation, or subluxation (Mayo types 2A and 2B; OTA type 21-B1) at 2 area hospitals between January 2002 and May 2014 to determine factors associated with reoperation. Bivariate and multivariable analysis was performed to determine which factors were associated with reoperation after a displaced olecranon fracture. Results Ninety-nine of the 392 fractures (25%) had a second operation, of which 92 (93%) were performed at least in part for implant removal (12 for wire migration [3% of all fractures, 12% of reoperations]). Accounting for other factors in multivariable analysis, younger age and female gender were factors independently associated with reoperation and implant removal, whereas technical factors were not. Conclusions Women and younger patients are more likely to have implants removed, regardless of the implants or the technique. We speculate that patients with a narrower, thinner elbow might prefer to remove the implants, but there may also be preferences unrelated to wire prominence

Item Type:	Thesis (Thesis)
Supervisor name:	Supervisor UMCG: and Bulstra, Prof. dr. S.K. MD and Head of the Orthopaedic Surgery Department, UMCG
Supervisor name:	Mellema, J.J. MD and Massachusetts General Hospital and PhD research fellow, Hand and Upper Extremity Service and External investigator: and Ring, David MD and Massachusetts General Hospital and Chief, Hand and Upper Extremity Service and Director of Research, Hand and Upper Extremity Service and Professor of Orthopaedic Surgery, Harvard Medical School
Faculty:	Medical Sciences
Date Deposited:	25 Jun 2020 10:55
Last Modified:	25 Jun 2020 10:55
URI:	https://umcg.studenttheses.ub.rug.nl/id/eprint/1615

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