Long-term results of olecranon fractures treated using the XS nail® system
Purpose: Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces. Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition, as well as neutralizing the strain inhibiting fracture he...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-11-01
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| Series: | Chinese Journal of Traumatology |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S1008127522000220 |
| _version_ | 1811312478731108352 |
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| author | Leonard Höchtl-Lee Matthias Spalteholz Tim Friedrich Raven Arash Moghaddam Wilhelm Friedl |
| author_facet | Leonard Höchtl-Lee Matthias Spalteholz Tim Friedrich Raven Arash Moghaddam Wilhelm Friedl |
| author_sort | Leonard Höchtl-Lee |
| collection | DOAJ |
| description | Purpose: Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces. Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition, as well as neutralizing the strain inhibiting fracture healing. The XS nail® (Intercus GmbH, Bad Blankenberg, Germany), an intramedullary implant exerting compression across the entire fracture surface, unlike plates, leaves a minimal extra-cortical profile, and can be secured with threaded locking wires, thereby retaining the anatomical reduction without displacement or steps within the articular surface, which was often found in tension band wiring. After encouraging initial results, the long-term outcome was assessed. Methods: This retrospective study evaluated the long-term outcome of patients surgically treated at our trauma center between January 2002 and December 2005 using the XS nail®. Patients over the age of 18 years eligible for the study must have undergone surgery for isolated, recent (less than 14 days) traumatic olecranon fractures, without concomitant injuries to the ipsilateral elbow and forearm. Further exclusion criteria were pseudarthrosis, re-fractures and osteotomy for distal humerus surgery, as well as polytraumatized patients unable to aid in their own recovery. Data were retrospectively gathered by standardised questionnaire and patient records, as well as surgery and anesthesiology reports. Data analysis was performed using Microsoft Office Excel® 2016. Results: There were 32 patients, 13 males (mean age 49.0 years) and 19 females (mean age 68.9 years) with 11 Schatzkers type D, 7 each type A and C, 5 type B and 2 type E at an average of 55.2 months, all showing complete consolidation. Of them, 6 patients had a loss of range of motion with more than 10° in the sagittal plane, and only 1 patient exceeded 10° reduction of supination. Twenty-five patients reported being pain-free under all circumstances, and all but 2 patients (93.75%) had returned to their previous activity level. The average disabilities of the arm, shoulder and hand score was 21.15 (range 0–88.3), and the overall Mayo elbow performance index was 91.87, without complications, such as wound infection, neurovascular impairment or premature hardware removal. Conclusion: Using the XS nail® system, all fracture types can be successfully treated and the rate of complications was lower than that treated by standard methods published in current literature. An excellent functional outcome, high range of motion as well as good retention of reduction without soft tissue irritation makes this a very suitable implant for fractures subject to tension. |
| first_indexed | 2024-04-13T10:36:51Z |
| format | Article |
| id | doaj.art-4ce05b6ef52043a4a85650b15279c59f |
| institution | Directory Open Access Journal |
| issn | 1008-1275 |
| language | English |
| last_indexed | 2024-04-13T10:36:51Z |
| publishDate | 2022-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Chinese Journal of Traumatology |
| spelling | doaj.art-4ce05b6ef52043a4a85650b15279c59f2022-12-22T02:50:01ZengElsevierChinese Journal of Traumatology1008-12752022-11-01256336344Long-term results of olecranon fractures treated using the XS nail® systemLeonard Höchtl-Lee0Matthias Spalteholz1Tim Friedrich Raven2Arash Moghaddam3Wilhelm Friedl4Aschaffenburg Trauma and Orthopaedic Research Group, Center for Orthopaedics, Trauma Surgery and Sports Medicine, Hospital Aschaffenburg-Alzenau GGmbH, Am Hasenkopf 1, Aschaffenburg, GermanyCenter for Orthopaedics and Trauma Surgery, Leipzig, GermanyAschaffenburg Trauma and Orthopaedic Research Group, Center for Orthopaedics, Trauma Surgery and Sports Medicine, Hospital Aschaffenburg-Alzenau GGmbH, Am Hasenkopf 1, Aschaffenburg, Germany; Corresponding author.Aschaffenburg Trauma and Orthopaedic Research Group, Center for Orthopaedics, Trauma Surgery and Sports Medicine, Hospital Aschaffenburg-Alzenau GGmbH, Am Hasenkopf 1, Aschaffenburg, GermanyDivision of Orthopaedics and Trauma Surgery, Rotkreuzklinik Wertheim GGmbH, Wertheim Am Main, GermanyPurpose: Olecranon fractures are particularly vulnerable to distraction and subsequent fracture dislocation due to the high tensile forces. Surgical treatment aims at reducing the fracture and restoring the anatomical joint surface condition, as well as neutralizing the strain inhibiting fracture healing. The XS nail® (Intercus GmbH, Bad Blankenberg, Germany), an intramedullary implant exerting compression across the entire fracture surface, unlike plates, leaves a minimal extra-cortical profile, and can be secured with threaded locking wires, thereby retaining the anatomical reduction without displacement or steps within the articular surface, which was often found in tension band wiring. After encouraging initial results, the long-term outcome was assessed. Methods: This retrospective study evaluated the long-term outcome of patients surgically treated at our trauma center between January 2002 and December 2005 using the XS nail®. Patients over the age of 18 years eligible for the study must have undergone surgery for isolated, recent (less than 14 days) traumatic olecranon fractures, without concomitant injuries to the ipsilateral elbow and forearm. Further exclusion criteria were pseudarthrosis, re-fractures and osteotomy for distal humerus surgery, as well as polytraumatized patients unable to aid in their own recovery. Data were retrospectively gathered by standardised questionnaire and patient records, as well as surgery and anesthesiology reports. Data analysis was performed using Microsoft Office Excel® 2016. Results: There were 32 patients, 13 males (mean age 49.0 years) and 19 females (mean age 68.9 years) with 11 Schatzkers type D, 7 each type A and C, 5 type B and 2 type E at an average of 55.2 months, all showing complete consolidation. Of them, 6 patients had a loss of range of motion with more than 10° in the sagittal plane, and only 1 patient exceeded 10° reduction of supination. Twenty-five patients reported being pain-free under all circumstances, and all but 2 patients (93.75%) had returned to their previous activity level. The average disabilities of the arm, shoulder and hand score was 21.15 (range 0–88.3), and the overall Mayo elbow performance index was 91.87, without complications, such as wound infection, neurovascular impairment or premature hardware removal. Conclusion: Using the XS nail® system, all fracture types can be successfully treated and the rate of complications was lower than that treated by standard methods published in current literature. An excellent functional outcome, high range of motion as well as good retention of reduction without soft tissue irritation makes this a very suitable implant for fractures subject to tension.http://www.sciencedirect.com/science/article/pii/S1008127522000220Olecranon fractureIntramedullary nailTreatmentDASHXS nail |
| spellingShingle | Leonard Höchtl-Lee Matthias Spalteholz Tim Friedrich Raven Arash Moghaddam Wilhelm Friedl Long-term results of olecranon fractures treated using the XS nail® system Chinese Journal of Traumatology Olecranon fracture Intramedullary nail Treatment DASH XS nail |
| title | Long-term results of olecranon fractures treated using the XS nail® system |
| title_full | Long-term results of olecranon fractures treated using the XS nail® system |
| title_fullStr | Long-term results of olecranon fractures treated using the XS nail® system |
| title_full_unstemmed | Long-term results of olecranon fractures treated using the XS nail® system |
| title_short | Long-term results of olecranon fractures treated using the XS nail® system |
| title_sort | long term results of olecranon fractures treated using the xs nail r system |
| topic | Olecranon fracture Intramedullary nail Treatment DASH XS nail |
| url | http://www.sciencedirect.com/science/article/pii/S1008127522000220 |
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