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Fixation of an olecranon osteotomy used for distal humerus surgery in a 24-year-old male
1%
35/4108
Simple transverse olecranon fracture in 33-year-old female
2%
63/4108
Comminuted olecranon fracture in 45-year-old male
84%
3457/4108
Severely comminuted proximal olecranon fracture in an osteoporotic 91-year-old female
12%
505/4108
Aphophyseal elbow fracture in 6-year-old male
0%
16/4108
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Bridge plating is most appropriately used for fixation of comminuted fractures which are not able to be fixed anatomically. Of the choices listed above, this would be most appropriate in a comminuted fracture in a 45-year-old male. In contrast, literature shows that severely comminuted, osteoporotic low-demand elderly are best treated with olecranon fracture excision and triceps advancement when possible. Bailey et al looked at the outcome of plate fixation of olecranon fractures. They concluded that plate fixation is effective for displaced olecranon fractures and leads to good functional outcome. There were low incidence of complications, although 20% did have removal of hardware due to irritation. Hak et al reviewed the fixation options for olecranon fractures. In their review, they state that comminuted olecranon fractures can be treated by limited-contact dynamic-compression plates. They also supported the use of supplemental bone graft to support comminuted depressed articular fragments. Fragment excision and triceps advancement is appropriate in selected cases in which open reduction seems unlikely to be successful, such as in osteoporotic elderly patients with severely comminuted fractures.
3.9
(26)
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