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Long-Term Clinical and Radiological Outcomes of Mayo IIA Olecranon Fractures Treated with High-Strength Transosseous
R García-Elvira1, J A López Tello2, D Martín Barreda3
1Servicio de Cirugía Ortopédica y Traumatología, Hospital Clínic de Barcelona, Universitat de Barcelona (UB), Barcelona, España; Facultad de Medicina y Ciencias de la Salud, Universitat de Barcelona (UB), Barcelona, España.
Introduction:
Olecranon fractures are common injuries, especially in the elderly population, in whom conventional osteosynthesis with tension band wiring (TBW) or plating (PF) is associated with high reoperation rates for hardware removal due to intolerance (up to 80% of surgically treated patients in the TBW group and 25% in those treated with PF). High-strength transosseous suture (TBS) has been proposed as an alternative to reduce these complications associated with conventional techniques, although few studies with long-term follow-up exist. The aim of this study was to assess, in the long term, the need for reoperation after the use of TBS in Mayo type IIA olecranon fractures in elderly patients, as well as their clinical and radiological outcomes.
Materials And Methods:
In 2022, a previously published cohort of 29 patients operated on between 2010-2018 using TBS was contacted. The sex distribution was 26 women (89.7%) and 3 men (10.3%). Of these, 19 could be evaluated (12 in person and 7 by telephone), with a mean follow-up of 7.41 years (range: 4,1-11,8 years). The need for hardware removal, joint function using the Oxford Elbow Score (OES) and the Mayo Elbow Performance Score (MEPS), elbow mobility, and radiological findings were analyzed.
Results:
The mean age of patients at follow-up was 79 years. No patient required hardware removal. Three patients (15.8%) reported mild discomfort, but without functional impact or desire for reoperation. In the patients assessed in person, the mean range of motion was 132° flexion and 5° extension; the mean OES was 47 points and the mean MEPS was 97.1 points, with 83.3% rated as excellent outcomes. All these patients showed radiographic union without signs of post-traumatic osteoarthritis.
Conclusions:
The high-strength transosseous suture technique appears to be a good alternative to conventional methods, providing reliable fixation, reducing associated complications, and lowering reoperation rates for hardware removal in elderly patients.
