Paediatric olecranon fractures: a systematic review.
Thomas J Holme1, Marta Karbowiak2, Magnus Arnander1,2
1St George's University Hospitals NHS Foundation Trust, London, UK.
EFORT Open Reviews
|June 9, 2020
Summary
Paediatric olecranon fractures displaced less than 4 mm heal well with non-operative treatment. Fractures displaced 4 mm or more benefit from operative management, with specific considerations for patient weight and associated injuries.
Area of Science:
- Orthopaedic surgery
- Paediatric orthopaedics
- Trauma surgery
Background:
- Olecranon fractures in children have poorly understood optimal management and long-term outcomes.
- A systematic review is needed to consolidate current evidence on paediatric olecranon fracture treatment.
Purpose of the Study:
- To systematically review the literature on the management of paediatric olecranon fractures.
- To analyze the long-term implications of different treatment strategies for these fractures.
Main Methods:
- Systematic review adhering to PRISMA guidelines.
- Inclusion of English-language studies on isolated paediatric olecranon fractures.
- Data extraction on demographics, classifications, treatments, and outcomes.
Main Results:
- Review of 15 articles (299 fractures in 280 patients).
- Non-operative treatment for fractures < 4 mm displacement yielded good results.
- Operative treatment for fractures ≥ 4 mm displacement showed generally good outcomes.
- Suture fixation failure associated with weight > 50 kg.
- Poorer outcomes noted with associated elbow injuries and in osteogenesis imperfecta patients.
Conclusions:
- Non-operative management is supported for isolated, undisplaced paediatric olecranon fractures.
- Operative management is recommended for displaced paediatric olecranon fractures (≥ 4 mm).
- Further research is needed due to the limited evidence base.
