Locking Compression Plates in Proximal Ulna Fractures: A Study on Functional Outcomes
https://doi.org/10.35401/2541-9897-2025-10-2-33-39
Abstract
Background: Proximal ulna fractures, such as olecranon and Monteggia fractures, can be challenging to treat.
Objective: To assess the effectiveness of locking compression plates (LCP) in stabilizing and promoting early mobilization in these fractures.
Materials and methods: This is a prospective study conducted at Saveetha Medical College and Hospital from January 2022 to December 2023. Patients with compound fractures, pediatric fractures, proximal bilateral forearm fractures, and those considered medically incompetent for surgery were excluded from the study.
Results: Of 20 patients with olecranon and Monteggia fractures, the majority had comminuted olecranon fractures. Most cases did not have associated injuries, while a few had radial head or coronoid injuries. Fracture union times varied, with some cases taking 12, 16, or 18 weeks to heal. Most patients achieved good elbow range of motion, exceeding 100° in 75% of cases. One patient experienced an exposed implant, one developed an infection, and 3 cases had restricted terminal pronation and supination. Functional outcomes assessed using the Mayo Elbow Performance score were excellent in 16 patients and good in 4 patients.
Conclusions: That comminuted olecranon and proximal ulna fractures can be effectively treated with LCP, resulting in good union and excellent clinical outcomes.
About the Authors
K. DwaraganathIndia
Kandavel Dwaraganath - MS, DNB, Assistant Professor, Department of Orthopaedics, Saveetha Institute of Medical And Technical Sciences.
Chennai
R. Rohit
India
Ravikumar Rohit - MS, Assistant Professor, Department of Orthopaedics, Saveetha Institute of Medical and Technical Sciences.
Chennai
Ch. Arun Kumar
India
Chandhuru Arun Kumar - MS, Associate Professor, Department of Orthopaedics, Saveetha Institute of Medical and Technical Sciences.
Thandalam, Chennai, Tamilnadu-602105
A. Subramanian
India
Arumugam Subramanian - DNB, Assistant Professor, Department of Orthopaedics, Saveetha Institute of Medical and Technical Sciences.
Chennai
References
1. Ring D. Elbow fractures and dislocations. In: Rockwood CA, Bucholz RW, Court-Brown CM, Heckman JD, Tornetta P, eds. Rockwood and Green's Fractures in Adults. Vol 1. 7th ed. Lippincott Williams & Wilkins; 2010:905-944.
2. Howard JL, Urist MR. Fracturedislocation of the radius and the ulna at the elbow joint; report of a case treated by excisional surgery and temporary transfixation of the joint with a Kirschner wire. Clin Orthop. 1958;12:276–284. PMID: 13619093.
3. Veillette CJ, Steinmann SP. Olecranon fractures. Orthop Clin North Am. 2008;39(2):229–vii. PMID: 18374813. https://doi.org/10.1016/j.ocl.2008.01.002
4. Wolfgang G, Burke F, Bush D, et al. Surgical treatment of displaced olecranon fractures by tension band wiring technique. Clin Orthop Relat Res. 1987;(224):192–204. PMID: 3665240.
5. Bailey CS, MacDermid J, Patterson SD, King GJ. Outcome of plate fixation of olecranon fractures. J Orthop Trauma. 2001;15(8):542–548. PMID: 11733669. https://doi.org/10.1097/00005131-200111000-00002
6. Boyer MI, Galatz LM, Borrelli J Jr, Axelrod TS, Ricci WM. Intra-articular fractures of the upper extremity: new concepts in surgical treatment. Instr Course Lect. 2003;52:591–605. PMID: 12690885.
7. Anderson ML, Larson AN, Merten SM, Steinmann SP. Congruent elbow plate fixation of olecranon fractures. J Orthop Trauma. 2007;21(6):386–393. PMID: 17620997. https://doi.org/10.1097/BOT.0b013e3180ce831e
8. Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg Am. 1985;67(9):1396–1401. PMID: 3908460.
9. Romero JM, Miran A, Jensen CH. Complications and re-operation rate after tension-band wiring of olecranon fractures. J Orthop Sci. 2000;5(4):318–320. PMID: 10982677. https://doi.org/10.1007/s007760070036
10. Chalidis BE, Sachinis NC, Samoladas EP, Dimitriou CG, Pournaras JD. Is tension band wiring technique the “gold standard” for the treatment of olecranon fractures? A long term functional outcome study. J Orthop Surg Res. 2008;3:9. PMID: 18294381. PMCID: PMC2265682. https://doi.org/10.1186/1749-799X-3-9
11. Helm RH, Hornby R, Miller SW. The complications of surgical treatment of displaced fractures of the olecranon. Injury. 1987;18(1):48–50. PMID: 3440616. https://doi.org/10.1016/0020-1383(87)90386-x
12. van Olden GD. VA-LCP anterior clavicle plate: the anatomically precontoured fixation system with angular stability for clavicle shaft. Musculoskelet Surg. 2014;98(3):217–223. PMID: 24163305. https://doi.org/10.1007/s12306-013-0302-z
13. Duckworth AD, Clement ND, White TO, Court-Brown CM, McQueen MM. Plate Versus tension-band wire fixation for olecranon fractures: a prospective randomized trial. J Bone Joint Surg Am. 2017;99(15):1261–1273. PMID: 28763412. https://doi.org/10.2106/JBJS.16.00773
14. Fyfe IS, Mossad MM, Holdsworth BJ. Methods of fixation of olecranon fractures. An experimental mechanical study. J Bone Joint Surg Br. 1985;67(3):367–372. PMID: 3997942. https://doi.org/10.1302/0301-620X.67B3.3997942
15. Gordon MJ, Budoff JE, Yeh ML, Luo ZP, Noble PC. Comminuted olecranon fractures: a comparison of plating methods. J Shoulder Elbow Surg. 2006;15(1):94–99. PMID: 16414476. https://doi.org/10.1016/j.jse.2005.06.003
16. Hume MC, Wiss DA. Olecranon fractures. A clinical and radiographic comparison of tension band wiring and plate fixation. Clin Orthop Relat Res. 1992;(285):229–235. PMID: 1446443.
17. Powell AJ, Farhan-Alanie OM, Bryceland JK, Nunn T. The treatment of olecranon fractures in adults. Musculoskelet Surg. 2017;101(1):1–9. PMID: 28050809. https://doi.org/10.1007/s12306-016-0449-5
18. Wegmann K, Engel K, Skouras E, et al. Reconstruction of Monteggia-like proximal ulna fractures using different fixation devices: a biomechanical study. Injury. 2016;47(8):1636–1641. PMID: 27242331. https://doi.org/10.1016/j.injury.2016.05.010
19. Buijze GA, Blankevoort L, Tuijthof GJ, Sierevelt IN, Kloen P. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg. 2010;130(4):459–464. https://doi.org/10.1007/s00402-009-0980-z.
20. Egol KA, Kubiak EN, Fulkerson E, Kummer FJ, Koval KJ. Biomechanics of locked plates and screws. J Orthop Trauma. 2004;18(8):488–493. PMID: 15475843. https://doi.org/10.1097/00005131-200409000-00003
Review
For citations:
Dwaraganath K., Rohit R., Arun Kumar Ch., Subramanian A. Locking Compression Plates in Proximal Ulna Fractures: A Study on Functional Outcomes. Innovative Medicine of Kuban. 2025;10(2):33-39. https://doi.org/10.35401/2541-9897-2025-10-2-33-39