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Percutaneous pinning
1%
5/585
Closed reduction and extension casting
3/585
Fragment excision and triceps advancement
0%
2/585
Open reduction and internal fixation with plate fixation
77%
450/585
Open reduction and internal fixation with tension band wire construct
20%
116/585
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The patient has sustained an isolated, closed fracture of the olecranon without associated instability. The bone is radiographically osteopenic and the fracture is displaced, comminuted, and includes articular marginal impaction. Plate fixation is preferred in the presence of comminution or associated transolecranon or radiocapitellar instability. Displaced fractures are generally treated surgically in an effort to restore articular congruity, restore extensor function, and to allow for early mobilization in an effort to maximize functional outcomes. A tension band wire construct is a commonly used technique but is reserved for simple fracture patterns without comminution. Excision and triceps advancement can be considered in elderly, low-demand patients that have small unreconstructable fracture patterns without associated elbow instability.
3.7
(30)
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