Olecranon Osteotomy Implant Removal Rates and Associated Complications.

OBJECTIVE

This study reports on olecranon osteotomy implant removal rates, fixation types, and associated complications.

DESIGN

Multicentre case series.

SETTING

Patients were identified through an electronic medical database at one Level 1 trauma center and three Level 2 trauma centers.

PATIENTS: Two hundred thirty-five patients were identified through the database, of which 92 patients met inclusion criteria.

INTERVENTION: Patients underwent olecranon osteotomy for fixation of distal humerus fractures and the implant used was at the surgeon's discretion.

MAIN OUTCOME MEASUREMENT: Implant removal rate.

RESULTS

Thirty-four of 92 (37.0%) patients underwent removal of implant from their olecranon osteotomy. Implant removal rates were as follows: 28 of the 63 patients for tension band wiring (TBW) (44.4%), 6 of the 18 patients for plates (33.3%), 0 of the 1 patient for cable-pin, and 0 of the 10 patients for osteotomies fixed with a screw fixation. Screw fixation was removed less frequently than TBW (P = 0.01). Screws were less commonly removed than all other fixation types (P = 0.01). TBWs (28/63) were more commonly removed than all other implants (6/29) (P < 0.05). The nonunion rate for olecranon osteotomies was 3.3%. TBWs (18/18) are more likely to be removed for implant irritation than plates. TBWs had an odds ratio of 3.29 for requiring implant removal if they were left >1 mm off of the olecranon tip.

CONCLUSION

In this study, 34 of the 92 (37%) patients undergoing an olecranon osteotomy for treatment of a distal humerus fracture required removal of olecranon implant. Screw fixation (0/10) was found to be removed less frequently than TBW fixation 28 of the 63 patients (44.4%).

LEVEL OF EVIDENCE: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.