Clinical application of home-made absorbable screws in treatment of olecranon fractures

Abstract

Objective To evaluate the results of internal fixation for olecranon fractures with home-made poly-DL-lactic acid (PDLLA) absorbable screws. Methods Fifty-four patients diagnosed as olecranon fracture were treated with internal fixation by PDLLA absorbable screws and tension band wiring respectively. In the experimental group, 22 patients were fixed using absorbable screws. In the control group,32 patients were fixed with tension band wiring. Results The follow-ups lasted for 7 to 49 (average,24. 8) months. All the fractures obtained solid union. The outcome was evaluated by Weseley rating system.The elbow function was good to excellent in 90.9 % of the patients in the experimental group, without pain or posterior apophysis of the elbow. Proximal radioulnar joint stiffness due to the screw was found in 1 patient,whose function of rotation recovered 5 months later. Invalid internal fixation was found by roentgenogram 2 weeks postoperatively in another 1 case who had been complicated with fractures of middle radius and ulna,and consequently had to be changed into tension band wiring. The elbow function recovered 12 months later.In the control group, the function was good to excellent in 93. 8%. Nine patients (28. 1% ) complained about posterior apophysis of the elbow and pain during motion. Roentgenogram revealed the K-wires backing out in 3 cases (9. 4% ). All the patients in this group had to have the internal fixators removed 8 to 15 months postoperatively. Data were statistically analyzed with SPSS 11.5. Rank sum test was used for pairwise comparison. There was no statistical significant difference in the good to excellent rate between the 2 groups ( W =845.0, P = 0. 485 ) . Conclusions Open reduction and internal fixation with home-made absorbable screws is an effective way for treatment of olecranon fractures. As the screws can be degraded completely,patients need not undergo a secondary operation, obviously reducing the treatment expenditure and time. Key words: Ulna fractures; Fracture fixation, internal; Absorbable screws