Short-Term Outcomes of Herbert Screw Fixation for Isolated Olecranon Fractures in Children: A Single-Institution Retrospective Study.

Yang Li,Yakun Liu,Dong Sun,Aiwu Li,Zhe Wang,Kelai Wang

doi:10.1007/s43465-022-00609-4

Yang Li, Yakun Liu + Show 4 more

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https://doi.org/10.1007/s43465-022-00609-4

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Abstract

The aim of this study was to assess the clinical and radiological outcomes of closed reduction with percutaneous Herbert screw fixation in children with isolated olecranon fractures. We retrospectively reviewed the records of children treated at our center for isolated olecranon fractures (Mayo type IIA) with closed reduction and percutaneous Herbert screw fixation. The related indices and data of the group were collected for comparative analysis after an average follow-up of 6-8months. The Herbert screws were removed by a second operation. Overall, 14 patients with an average age at the time of injury of 11.36 (range 10-14) years were included. All patients had good radiological and clinical outcomes at 6-8months postoperatively; all had normal elbow ranges of motion and showed complete bone healing on radiographs. There were no foreign body irritation, implant migration, or osteoarthritis cases. Premature epiphyseal closure was noted in six patients. The average QuickDASH score was 1.58. Fixation of olecranon fractures with Herbert screws is a safe and easy method in young patients, leading to good functional and radiological results. Nonetheless, determination of the effects of this treatment method on the olecranon ossification center requires long-term follow-up.

Highlights

Various fixation methods can be used for the treatment of displaced olecranon fractures, there are no clear indications in the current literature regarding which surgical technique should be adopted
Various fixation methods can be used for the treatment of displaced olecranon fractures, such as isolated pinning, percutaneous screw fixation, cerclage with Kirschner wires, pinning with threaded pins with adjustable lock, and tension band wire (TBW) fixation [1, 5, 6], there are no clear indications in the current literature regarding which surgical technique should be adopted for the treatment of Mayo type IIA olecranon fractures
We retrospectively reviewed the records of children treated at the Qilu Hospital of Shandong University for olecranon fractures by closed reduction with percutaneous Herbert screw fixation from January 2016 to December 2018

Summary

Introduction

Various fixation methods can be used for the treatment of displaced olecranon fractures, there are no clear indications in the current literature regarding which surgical technique should be adopted. We evaluated the clinical and radiological outcomes of closed reduction with percutaneous Herbert screw fixation in children with isolated olecranon fractures. Only 1.7% of healthy children are likely to have olecranon fracture[1]. Olecranon fractures may occur when the elbow is extended or flexed by external forces, with a varus or valgus stress on the joint. Most olecranon fractures in children can be treated conservatively with good results. Fractures with a displacement of less than 2 mm are typically treated with cast immobilization, and long-term follow-up is performed to ensure good results [1, 3]. Evans and Graham suggested that displacements of 2–4 mm represent a gray zone in which the choice for surgical or non-surgical treatment has to be individually considered depending on the biomechanical stability, as assessed clinically by an experienced surgeon [4]

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