Surgical Treatment of Olecranon Fractures in Adults, Fractures Patterns, Surgical Technique and Outcome after 10-30 Years.

The olecranon is the most proximal articulating part of the ulna. Together with
the coronoid process it forms the trochlear notch of the ulna, which
articulates with the distal humerus. Due to its subcuatenous position, the
olecranon is vulnerable to direct trauma. Most olecranon fractures are
displaced and unstable. Treatment goals for olecranon fractures should consist
of the following; articular restoration, preservation of motor power of
extension, stability, avoidance of stiffness, and limitation of possible
associated complications. Several treatment options have been advocated in the
past; tension band wire technique, intramedullary screw (with or without
tension band wire) and plate fixation, but the treatment option depends on the
nature of the fracture. A few studies document good or excellent elbow function
within a couple of years of operative fixation of a fracture of the olecranon,
however the long-term results in those patients are not well investigated. It
would be useful to know if patients lose motion, have more pain, develop
arthrosis, or require additional operations ten years or more after a fracture
of the olecranon.

We propose a protocol to invite patients with olecranon fractures identified
from the AMC database to return for evaluation and radiographs in order to
collect long term (>10 years) data regarding the outcomes of these fractures.

All patients treated for olecranon fractures in the Academic Medical Centre in
Amsterdam from the first available year of registry in the AO AMC trauma
database from 1973 until 1998, will be invited to return to our out-patient
clinic for a long term follow up (IRB approved).

Outcome instruments, such as the Mayo Elbow Performance Index and ASES
(American Shoulder and Elbow Society) Elbow Score, will be used to assess
subjective and objective functional outcome. The DASH-questionnaire will be
used to evaluate functional outcome from the patient*s point of view.
Radiographs will be taken to evaluate postoperative alignment.

Burden: One time visit to the AMC Amsterdam.

Risk: Very low risk classified as trivial risk for X-photography of the elbow.