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Incidence and Management of Articular Impaction in Geriatric Olecranon Fractures
Harsh Wadhwa1, L Henry Goodnough, Andrea K Finlay
1From the Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA (Wadhwa, Goodnough, Finlay, DeBaun, Bishop, and Gardner), the Department of Orthopaedic Surgery, Santa Clara Valley Medical Center, San Jose, CA (Hecht and Lucas), and the Department of Orthopaedic Surgery, University of Washington Harborview Medical Center, Seattle, WA (Campbell).
Introduction:
Olecranon fractures are common in the elderly. Articular impaction is encountered occasionally, but the incidence and outcomes after treatment of this injury pattern have not been well characterized.
Methods:
We evaluated a cohort of geriatric olecranon fractures to determine the incidence of articular impaction and describe a technique for open reduction and internal fixation.
Results:
Of the 63 patients in our series, 31 had associated intraarticular impaction (49.2%). Patients with articular impaction did not have significantly different rates of postoperative complications (11/31, 35.5% versus 10/31, 32.3%; P = 1.00) or revision surgery (10/31, 32.3% versus 8/31, 25.8%; P = 0.780) compared with those without articular impaction.
Conclusion:
Articular impaction is a common feature of geriatric olecranon fractures. Surgeons must maintain a high index of suspicion and have a surgical plan in place for managing this component of the injury.
