A Retrospective Study on the Outcome of Different Fixation Methods After Olecranon Osteotomy

Study Overview
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Brief Summary
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Humeral intercondylar fractures are very challenging in clinical treatment. There are many problems not clear. One of the important problems remained to be solved is which fixation method can achieve the best effects after olecranon osteotomy. Therefore, the investigators are going to perform a retrospective analysis of patients with distal humerus fractures admitted to their hospital in 2012-2017 to compare the functional outcomes of elbow joints with tension-band fixation and plate fixation after olecranon osteotomy.

Detailed Description
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Humeral intercondylar fractures are very challenging in clinical treatment. Because the humeral intercondylar fracture is comminuted and often occurs in elderly patients with osteoporosis, it is difficult to achieve rigid fixation during the operation and failure of fixation occurs from time to time after the operation. Nonunion and reoperation have brought great sufferings to the patients.In recent years, both surgical methods and technique of internal fixation have been greatly improved, but there are still many problems not clear. Olecranon osteotomy has been proven to be an effective approach for comminuted intercondylar fractures and there are different fixation methods to fix the proximal ulna after intercondylar fixation. However, it is not clear which method can achieve the best effects. Therefore, the investigators are going to perform a retrospective analysis of patients with distal humerus fractures admitted to their hospital in 2012-2017 to compare the functional outcomes of elbow joints with tension-band fixation and plate fixation after olecranon osteotomy.

Official Title
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A Retrospective Study on the Outcome of Different Fixation Methods After Olecranon Osteotomy

Conditions
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Distal Humerus Fractures, Osteotomy, Fixation Device; Complications

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients over 18 years old; Distal humerus fractures. Exclusion Criteria: Pathological fractures; Combined with fractures of ipsilateral upper limb; Fracture over 2 weeks; Patients who refused surgical treatment; Patients who were unable to obtain the 1 year follow-up data after the operation.

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 90 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Tension-band Fixation Group<br>Patients with distal humerus fractures admitted to our hospital in 2012-2017 who had been performed open reduction and internal fixation through olecranon osteotomy approach were selected. All patients were devided into two groups by different fixation method. Patients who had been performed tension-band fixation after olecranon osteotomy were classified into Tension-band Fixation Group. | |
| Plate Fixation Group<br>Patients with distal humerus fractures admitted to our hospital in 2012-2017 who had been performed open reduction and internal fixation through olecranon osteotomy approach were selected. All patients were devided into two groups by different fixation method. Patients who had been performed plate fixation after olecranon osteotomy were classified into Plate Fixation Group. | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Functional result of elbow (objective) | Assess function of patients' affected elbow by MEPS (Mayo elbow performance score) | 1 year post-op | 
| Functional result of elbow (subjective) | Assess function of patients' affected elbow by and DASH (Disabilities of arm, shoulder and hand) | 1 year post-op | 
| Range of motion of elbow | Measure and record the ROM of the affected elbow，including flexion, extension, pronation and supination degree. | 1 year post-op | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Complication: infection | Record patients' information about infection if any, including superficial and deep infection. | 1 year post-op | 
| Complication:stiffness | Record whether the patients had elbow stiffness (ROM<100° or arthrolysis having been performed) | 1 year post-op | 
| Complication: internal fixation irritation | Record whether there were internal fixation irritations | 1 year post-op | 
| Complication: failure of internal fixation | Record whether the patients have gone through internal fixation failure | 1 year post-op | 
| Complication: post-traumatic arthritis | Record if the patients have developed into post-traumatic arthritis, if any, record the degree. | 1 year post-op | 
| severity of ulnar nerve injury | Assess and record severity of ulnar nerve injury (paralysis or weakness of intrinsic muscle of hand or parathesia of ring and little finger) | 1 year post-op | 
| severity of pain | Assess severity of pain by VAS (Visual analogue scale) | 1 year post-op | 
| nounion | Record if there is nonunion of the olecranon (evaluated by X-ray or CT scan) | 1 year post-op | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Distal Humerus Fractures, Olecranon Osteotomy, Plate Fixation, Tension-band Fixation