Olecranon Osteotomy Implant Removal Rates and Associated Complications

Objective: This study reports on olecranon osteotomy implant removal rates, fixation types, and associated complications.

Design: Multicentre case series.

Setting: Patients were identified through an electronic medical database at one Level 1 trauma center and three Level 2 trauma centers.

Patients: Two hundred thirty-five patients were identified through the database, of which 92 patients met inclusion criteria.

Intervention: Patients underwent olecranon osteotomy for fixation of distal humerus fractures and the implant used was at the surgeon's discretion.

Main Outcome Measurement: Implant removal rate.

Results: Thirty-four of 92 (37.0%) patients underwent removal of implant from their olecranon osteotomy. Implant removal rates were as follows: 28 of the 63 patients for tension band wiring (TBW) (44.4%), 6 of the 18 patients for plates (33.3%), 0 of the 1 patient for cable-pin, and 0 of the 10 patients for osteotomies fixed with a screw fixation. Screw fixation was removed less frequently than TBW (P = 0.01). Screws were less commonly removed than all other fixation types (P = 0.01). TBWs (28/63) were more commonly removed than all other implants (6/29) (P < 0.05). The nonunion rate for olecranon osteotomies was 3.3%. TBWs (18/18) are more likely to be removed for implant irritation than plates. TBWs had an odds ratio of 3.29 for requiring implant removal if they were left >1 mm off of the olecranon tip.

Conclusion: In this study, 34 of the 92 (37%) patients undergoing an olecranon osteotomy for treatment of a distal humerus fracture required removal of olecranon implant. Screw fixation (0/10) was found to be removed less frequently than TBW fixation 28 of the 63 patients (44.4%).

Level Of Evidence: Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.