Surgical Management of Displaced Pediatric Olecranon Fracture and other Associated Elbow Injuries

Introduction:
Multiple surgical techniques are used for open reduction and internal fixation of pediatric olecranon fractures. Both tension band wiring and tension band suturing are noted to be reliable techniques.

several studies described surgical technique of a tension band construct with removable K-wires and absorbable suture, allowing the K-wires to simply be removed at 4 weeks in the outpatient setting.

the purpose of this study the evaluation pediatric patients treated operatively according to this described surgical technique on the one hand using absorbable versus nonabsorbable sutures for tension band. On the other hand, demonstrating outcome of isolated olecranon fractures compared to associated olecranon fractures with other elbow injuries in the pediatric population.

Methods:
All patients less than 16 years old, diagnosed with displaced olecranon fracture either isolated or associated other elbow fracture and treated operatively with the specified technique between January 2011 to December 2019 at our institution were retrospectively enrolled in this study with institutional ethics committee approval.

Results:
A total of 31 patients, 24 males and 7 females with a mean age of 8.7 years old (range 1–16 years), were treated operatively at our hospital between January 2011 and December 2019, for a displaced fracture of the olecranon. 15 patients sustained a major concomitant injury to the same elbow. 11 radial neck fractures, 3 lateral condyle and one fracture dislocation of the elbow.

For 58% of cases was used absorbable suture vs 42% of cases nonabsorbable suture for tension band suturing.

the clinical and radiological outcome was similar good for the simple and complex fracture group. Both absorbable and nonabsorbable sutures shows similar good clinical results.

Conclusion:
This described surgical technique seem to be reliable for treatment of simple and complex displaced pediatric olecranon fractures. For tension band suturing can be used absorbable and nonabsorbable sutures with no significant clinical difference