A posterior approach to the elbow utilizing an olecranon osteotomy has been shown to provide excellent visualization of the distal humerus articular surface. However, many bony stabilization and fixation methods for the olecranon osteotomy are usually prominent, frequently symptomatic, and often require a second operation for removal. This paper evaluates the use of an innovative device, the olecranon sled, in fixation of olecranon osteotomies for exposure of intra-articular distal humerus fractures and provides follow-up results. A retrospective review of all patients with intra-articular distal humerus fracture treated through an olecranon osteotomy approach and fixed with an olecranon sled, between September 2008 and December 2011 was conducted. Charts and radiographs were reviewed to determine olecranon union or nonunion, presence of symptomatic hardware, and need for secondary surgery to remove symptomatic olecranon fixation. Fourteen patients were included in the study. Average clinical follow-up was 33.5 weeks (range, 6 to 118 wk). There were no olecranon nonunions. One patient underwent additional surgery for symptomatic hardware removal (7.1%). Two additional procedures were performed; 1 for revision open reduction and internal fixation of distal humerus fracture nonunion (7.1%) and 1 for release of elbow contracture (7.1%). Although follow-up is limited, the use of this device has been associated with excellent rates of olecranon union with a low rate of symptomatic hardware requiring removal.
*Department of Orthopaedic Hand Surgery, The Philadelphia Hand Center
†Department of Orthopaedic Surgery, Thomas Jefferson University Hospital
‡Section Head of Hand and Upper Extremity Surgery, Department of Orthopaedics, Christiana Care
§Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, The Philadelphia Hand Center
Conflicts of Interest and Source of Funding: J.D.P. and M.S.R. or an immediate family member have received prior reimbursement for speaking engagements related to TriMed products. None of the authors or institutions have received financial assistance for the current research or manuscript preparation. For the remaining authors none were declared.
Address correspondence and reprint requests to Justin C. Wong, MD, Department of Orthopaedic Surgery, Thomas Jefferson University Hospital, 1015 Walnut Street, Rm 801 Curtis Building, Philadelphia, PA 19107. E-mail: email@example.com.