Abstract
Recent concerns regarding the prospective growth disruption of the olecranon apophysis in skeletally immature patients with intramedullary nail fixation for ulnar fractures has been documented. This retrospective review investigated the long-term functional and radiological outcomes of intramedullary nail fixation through the olecranon apophysis in skeletally immature patients.
Intramedullary nail fixation through the olecranon apophysis in skeletally immature patients is an effective, efficient procedure with excellent functional outcomes and without radiographic evidence of growth disruption at maturity.
To investigate the long-term radiological and functional outcomes on the olecranon apophysis after intra-medullary nail fixation in skeletally immature ulnar fractures.
Retrospective review of patients who where skeletally immature at the time of intramedullary nail fixation through the olecranon apophysis. Patients were excluded if they had previous forearms fractures or fracture of the contralateral forearm. Functional measures included the “Activities Scale for Kids (ASK)”, “Disabilities of the Arm, Shoulder and Hand (DASH)” and “Elbow Assessment Form (EAF)” questionnaires. Radiological outcomes where independently evaluated for ulnar, olecranon, coronoid and trochlear notch proportions at follow-up and initial post-op radiographic data. All patients had a clinical exam and the injured forearm outcomes were compared to the contralateral forearm.
Nineteen patients were assessed. The average age at surgical intervention was 10.8 years (range, 1.6–15.9) with a mean follow up time of 3.4 years (range, 1.2–7.2). We outlined the demographics, clinical outcomes and functional questionnaire outcomes for the study cohort. Detailed radiographic measurements for ulnar, olecranon, coronoid and trochlear notch proportions are outlined also.
Intramedullary nail fixation through the olecranon apophysis in skeletally immature patients is an effective, efficient procedure with excellent functional outcomes and without radiographic evidence of growth disruption at maturity. When skeletally immature ulnar fractures require an intramedullary nail fixation, disrupting the olecranon apophysis has not been shown to affect the long-term functional and radiological outcomes.
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