Comminuted olecranon fractures: a comparison of plating methods

The relative strength of posterior plating and dual medial-lateral plating for comminuted olecranon fractures has not been evaluated. Fifteen male cadaveric elbows with simulated highly comminuted olecranon fractures were tested to failure via cantilever bending. The strength of dual medial-lateral plates and a single posterior plate with and without an intramedullary screw was evaluated. The mean bending moment at failure for the dual-plated specimens was 30.0 +/- 7.5 Nm. The mean bending moment at failure for specimens with a posterior plate without an intramedullary screw was 34.5 +/- 9.1 Nm. The mean bending moment at failure for specimens with a posterior plate and an intramedullary screw was 44.5 +/- 6.9 Nm; this was significantly greater than for dual-plated specimens (P < .05) but not for specimens with a posterior plate without an intramedullary screw. The posterior plate with an intramedullary screw was the most stable construct tested and may, therefore, be the preferred method of fixation for comminuted olecranon fractures. This construct was significantly (48%) stronger than dual medial and lateral plating.