![]() Caterini et al 15 used morphology and displacement, Gaddy et al 16 used displacement alone, Matthews 1 used a combination of displacement and associated injuries, Papavasiliou et al 17 used extra/intra-articular status, and Zionts and Moon 18 used morphology.ĭue to the wide variation in reporting of fracture type between studies it is not possible to formally aggregate the data. The other five studies designed their own classification systems. The Horne and Tanzer, and Mayo systems are based upon adult fractures. The Salter-Harris classification is a generic paediatric physeal classification system. The AO PCCF is a generic paediatric classification system based upon morphology. Bracq is a paediatric specific classification system describing the orientation of the fracture line (distal/oblique/parallel). 14 Of these, the Evans system is a comprehensive paediatric olecranon specific system based upon anatomic site, fracture configuration, intra-articular displacement, and associated injuries. Only 12 studies defined a classification system, of which seven used a previously published system (AO Paediatric Comprehensive Classification of Long-Bone Fractures (PCCF), 8, 9 Bracq, 10 Salter-Harris, 11 Horne and Tanzer, 12 Evans, 13 Mayo). Retrospective comparative study (OI patients) Retrospective comparative study (OI and non-OI patients) This systematic review aims to provide a concise update on the literature of isolated paediatric olecranon fractures, summarizing surgical indications, treatment options and expected outcomes. The long-term implications of an olecranon fracture involving the physis and surgical hardware such as wires potentially crossing the physis are also unclear. 5 Surgical indications in paediatric patients, however, are less clear, and often confusion arises as to the optimal surgical technique to employ in the growing skeleton across an open physis in this population. 3– 5 Those being treated operatively are typically treated with either tension band techniques, or plate fixation. ![]() The surgical indications in adult patients have been well studied, with only patients with truly undisplaced fractures (Mayo Type I), patients unfit for surgery, or elderly patients being treated non-operatively. 1 In adults, olecranon fractures are more common, representing 10% of all elbow fractures. Prospective, randomised controlled trials of matched patients and fracture patterns comparing operative techniques are needed as there is a lack of level I/II evidence to support the use of one implant over another.Olecranon fractures account for 4% of all paediatric elbow fractures, and are associated with other ipsilateral elbow injuries up to 20% of the time, which in turn are associated with poorer outcomes. Non-operative management in the elderly comorbid patient remains controversial. There may be an emerging role for intramedullary nail fixation. Currently, there exits a lack of studies comparing these treatments. Displaced complex injuries necessitate locking plate fixation. Non-displaced fractures can be treated conservatively. These should be managed with tension band wire constructs. 10% of all upper limb fractures involve the olecranon, and most are simple two-part injuries. ![]() Our novel illustrations aim to educate the reader, and our treatment algorithm provides guidance for management. An additional focus was placed on the evidence base for and surgical outcomes of tension band wiring for common two-part fractures. A literature review of peer-reviewed publications in international orthopaedic journals detailing olecranon fracture treatment was conducted. We aim to review the available literature to guide the orthopaedic surgeon on the management of these fractures. ![]() Currently, there are few studies comparing fracture treatments. They are usually managed surgically with open reduction and either tension band wiring or plate fixation.
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