The aim of this study is to report the results of a case series of olecranon fractures and olecranon osteotomies treated with two bicortical screws. Data was collected retrospectively for all olecranon fractures and osteotomies fixed with two bicortical screws between January 2008 and December 2019 at our institution. The following outcome measures were assessed; re-operation, complications, radiological loss of reduction, and elbow range of flexion-extension.Aims
Methods
Cubitus varus is the most common late complication of a supracondylar
fracture of the humerus in children. Correction can be performed
using one of a number of techniques of osteotomy but each has disadvantages.
We describe a new technique for correcting post-traumatic cubitus
varus using a lateral closing wedge isosceles triangular osteotomy. A lateral closing wedge isosceles triangular osteotomy was performed
in 25 patients (15 male and ten female with a mean age of 9.5 years
(6 to 12)) between May 2010 and April 2013. All patients had cubitus
varus secondary to malunion of a supracondylar fracture, with good
function of the elbow and a full range of movement. The osteotomy
lines were marked on the bone with an isosceles triangular template
made before surgery, after which the osteotomy was performed leaving
the medial cortex intact. Fixation was performed using two lateral
2 mm Kirschner (K)-wires and patients were immobilised in an above-elbow
plaster. By six to eight weeks callus was present and the wires
and cast were removed. Patients were reviewed at four and six weeks,
three, six and 12 months and then every two years until skeletal
maturity. Clinical and radiographic outcomes were categorised as excellent,
good or poor.Aims
Patients and Methods
Revision total elbow arthroplasty (TEA) is often challenging.
The aim of this study was to report on the clinical and radiological
results of revision arthroplasty of the elbow with the Latitude
TEA. Between 2006 and 2010 we used the Latitude TEA for revision in
18 consecutive elbows (17 patients); mean age 53 years (28 to 80);
14 women. A Kudo TEA was revised in 15 elbows and a Souter-Strathclyde
TEA in three. Stability, range of movement (ROM), visual analogue score (VAS)
for pain and functional scores, Elbow Functional Assessment Scale
(EFAS), the Functional Rating Index of Broberg and Morrey (FRIBM)
and the Modified Andrews’ Elbow Scoring System (MAESS) were assessed
pre-operatively and at each post-operative follow-up visit (six,
12 months and biennially thereafter). Radiographs were analysed
for loosening, fractures and dislocation. The mean follow-up was
59 months (26 to 89).Aims
Patients and Methods
We report our experience of performing an elbow
hemiarthroplasty in the treatment of comminuted distal humeral fractures
in the elderly patients. A cohort of 42 patients (three men and 39 women, mean age 72;
56 to 84) were reviewed at a mean of 34.3 months (24 to 61) after
surgery. Functional outcome was measured with the Mayo Elbow Performance
Score (MEPS) and range of movement. The disabilities of the arm,
shoulder and hand questionnaire (DASH) was used as a patient rated
evaluation. Complications and ulnar nerve function were recorded.
Plain radiographs were obtained to assess prosthetic loosening,
olecranon wear and heterotopic bone formation. The mean extension deficit was 23.5° (0° to 60°) and mean flexion
was 126.8° (90° to 145°) giving a mean arc of 105.5° (60° to 145°).
The mean MEPS was 90 (50 to 100) and a mean DASH score of 20 (0
to 63). Four patients had additional surgery for limited range of
movement and one for partial instability. One elbow was revised
due to loosening, two patients had sensory ulnar nerve symptoms,
and radiographic signs of mild olecranon wear was noted in five
patients. Elbow hemiarthroplasty for comminuted intra-articular distal
humeral fractures produces reliable medium-term results with functional
outcome and complication rates, comparable with open reduction and
internal fixation and total elbow arthroplasty. Cite this article:
The aim of this review is to address controversies
in the management of dislocations of the acromioclavicular joint. Current
evidence suggests that operative rather than non-operative treatment
of Rockwood grade III dislocations results in better cosmetic and
radiological results, similar functional outcomes and longer time
off work. Early surgery results in better functional and radiological
outcomes with a reduced risk of infection and loss of reduction compared
with delayed surgery. Surgical options include acromioclavicular fixation, coracoclavicular
fixation and coracoclavicular ligament reconstruction. Although
non-controlled studies report promising results for arthroscopic
coracoclavicular fixation, there are no comparative studies with
open techniques to draw conclusions about the best surgical approach.
Non-rigid coracoclavicular fixation with tendon graft or synthetic
materials, or rigid acromioclavicular fixation with a hook plate,
is preferable to fixation with coracoclavicular screws owing to
significant risks of loosening and breakage. The evidence, although limited, also suggests that anatomical
ligament reconstruction with autograft or certain synthetic grafts
may have better outcomes than non-anatomical transfer of the coracoacromial
ligament. It has been suggested that this is due to better restoration
horizontal and vertical stability of the joint. Despite the large number of recently published studies, there
remains a lack of high-quality evidence, making it difficult to
draw firm conclusions regarding these controversial issues. Cite this article:
