Intramedullary cancellous screw fixation of simple olecranon fractures

Abstract

Olecranon fractures and osteotomies are treated with either tension-band wiring or plate-screw fixation; however, these methods of fixation have high rates of symptomatic hardware, resulting in revision surgery. We describe the novel use of intramedullary noncannulated long screws to gain rigid internal fixation and allow early range of motion. Our procedure differs from traditional intramedullary olecranon fixation as the longer screws, which can commonly be found on many pelvic fixation sets, allow for endosteal purchase at the isthmus of the ulna, which increases the pull-out strength of the screw. This procedure can be done quickly and requires minimal exposure, which minimises anaesthetic exposure, blood loss, and tourniquet time. The construct is not palpable subcutaneously and therefore is less likely to result in symptomatic hardware and revision surgery.