Long-term outcomes after different types of Horne and Tanzer olecranon fractures

Ralph Hasserius,Fredrik Hertervig,Per-Olof Josefsson,Thord Von Schewelov,Jack Besjakov

doi:10.1007/s00402-020-03453-z

Ralph Hasserius, Fredrik Hertervig + Show 3 more

Open Access

https://doi.org/10.1007/s00402-020-03453-z

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Abstract

BackgroundIt is unclear whether the outcomes differ after different Horne and Tanzer types of olecranon fractures.Materials and methodsWe evaluated 40 men and 55 women with isolated olecranon fractures, journals and radiographs from fracture event. The fractures were classified according to Horne and Tanzer. After a mean 19 years after the fracture events, we evaluated subjective, clinical and radiographic outcomes, using the uninjured arms as controls.Results95% of patients with type I fractures reported, at follow-up, no differences between the elbows, 80% with type II fractures and 95% with type III fractures (p = 0.43). The three types of fractures had no differences in elbow range of motion or hand grip strength (when comparing injured and uninjured arms) and the proportions of individuals with radiographic elbow degenerative changes or joint space reduction were no different (all p > 0.05). Individuals with elbow degenerative changes had no inferior subjective elbow function compared to individuals with normal radiographs (p = 0.66), in contrast to those with joint space reduction compared to individuals with normal radiographs (p < 0.001).InterpretationAll types of Horne and Tanzer olecranon fractures have favourable long-term outcome. Elbow joint space reduction is associated with inferior subjective elbow function while degenerative changes are not.

Highlights

Fractures of the olecranon account for around 10% of all upper extremity fractures [1,2,3]
The primary aim of this study was to determine if different Horne and Tanzer type of olecranon fractures have different clinical and radiographic long-term outcomes, and the secondary to evaluate whether posttraumatic radiographic elbow changes are associated with an inferior clinical outcome
All three types of Horne and Tanzer fractures were associated with degenerative changes but not with joint space reduction (Table 4)

Summary

Introduction

Fractures of the olecranon account for around 10% of all upper extremity fractures [1,2,3]. No study has to our knowledge evaluated if the favorable long-term outcome accounts for all subtypes of olecranon fractures. The primary aim of this study was to determine if different Horne and Tanzer type of olecranon fractures have different clinical and radiographic long-term outcomes, and the secondary to evaluate whether posttraumatic radiographic elbow changes are associated with an inferior clinical outcome. It is unclear whether the outcomes differ after different Horne and Tanzer types of olecranon fractures. Elbow joint space reduction is associated with inferior subjective elbow function while degenerative changes are not

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