Early range of motion exercise in pediatric patients with olecranon fractures treated with tension band suture with double loops and double knots.

Abstract:

BACKGROUND:Pediatric patients with olecranon fractures are uncommon. The tension band suture technique was introduced to reduce the burden of implant removal and other complications. However, to our knowledge, early range of motion (ROM) exercise has not been introduced in this population of patients. Double Vicryl loops and knots with 2 cross-pins are used to maintain the benefits of the tension band suture technique and to enhance fixation tensile strength. We believe that early ROM exercises could be achieved without nonunion or fixation failure. METHODS:Twelve pediatric patients with olecranon fractures were treated with tension band suture with double loops and knots between 2004 and 2015. Vicryl No. 1 was used for wiring. ROM exercises were initiated 1 week postoperatively with a customized functional brace. Early functional outcomes were evaluated by the Mayo Elbow Performance Score at every visit after 8 weeks postoperatively. RESULTS:Nine boys and 3 girls (average age, 10.6 years; range, 5 years 7 months-16 years 2 months) were included in the study. Initial displacement and angulation of the fractures were 5 mm (2-7 mm) and 12° (4°-25°), respectively. Two cases had radial neck fractures of the ipsilateral elbow. All patients had a perfect Mayo Elbow Performance Score after 8 weeks postoperatively. Pin removals were performed at 13.1 weeks. No complications, including growth arrest, were observed. DISCUSSION/CONCLUSION:Tension band suture with double loops and knots, combined with early ROM exercise, may be a complete alternative to tension band wiring.

journal_name

J Shoulder Elbow Surg

authors

Kim TH,Lee DH,Han KJ,Choi WS,Cho JH

doi

10.1016/j.jse.2017.03.004

subject

Has Abstract

pub_date

2017-07-01 00:00:00

pages

e227-e231

issue

7

eissn

1058-2746

issn

1532-6500

pii

S1058-2746(17)30149-0

journal_volume

26

pub_type

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