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Intramedullary screw
0%
7/1400
Kirschner wire tension band
3%
42/1400
Total elbow arthroplasty
17%
242/1400
Fragment excision and triceps advancement
61%
856/1400
Dorsal bridge plating
243/1400
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Multiple treatments exist for olecranon fractures. Tension band construct (Illustration A) and intramedullary screw or k-wire placement are typically reserved for non-comminuted olecranon fractures, whereas plate and screw fixation (Illustration B) is used for comminuted fractures. Hak et al review olecranon fracture treatment and state that fragment excision and triceps advancement is most appropriate in elderly, osteoporotic patients with severely comminuted fractures involving the proximal 30-40% of the olecranon. Veillette et al state that when performing a triceps advancement for treatment of an olecranon fracture, between 50% and 70% of the olecranon articular surface can be excised without compromising elbow stability provided the coronoid and distal trochlea are preserved. When excision and triceps advancement is performed, the triceps should be attached adjacent to the articular surface.
3.1
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