Table 3.
Surgical management and outcomes
| Authors | TBW | TBS | Other | Post-op rehab | Clinical outcomes | Radiological outcomes |
|---|---|---|---|---|---|---|
| Caterini et al15 | – | – | 4 (cerclage wire), 1 (screw fixation) | Cast for 4 weeks | Good: 3/4 cerclage wires, 1/1 screw fixation Poor: 1/4 cerclage wires (inadequate intra-operative reduction) |
Severe radiographic OA in 1 treated with cerclage wires due to inadequate reduction |
| Corradin et al9 | – | 10 | 12 (screw fixation) | Cast for 4–6 weeks | All returned to previous levels of daily and sporting activity. TBS: Quick DASH 1.82, 1 case 15–20 degrees loss of extension. Screw fixation: QuickDASH 3.42, 3 cases 15–20 degrees loss of extension | All cases good reduction with < 2 mm residual displacement No adverse radiological features |
| Gaddy et al16 | 10 | – | – | Cast (1–4 weeks) then protected active-motion therapy | All satisfactory | No evidence of growth disturbance of the olecranon apophysis |
| Gicquel et al10 | – | – | 4 (Fixano screw fixation) | Cast for 3–4 weeks | Excellent (3), good (1 – imperfect reduction that had not remodelled by 17 months) Pins removed at 6–8 weeks |
Radiological – Satisfactory (3), poor (1 – persistence of displacement following surgery) |
| Gwynne-Jones11 | 4 | – | – | Cast for 3 weeks | Limited ROM (10 degrees loss of extension): 2/4 | Not stated |
| Karlsson et al12 | 2 | – | 6 (figure of eight wire), 1 (rushpin), 2 (closed reduction and casting) | Cast for 2–6 weeks (mean 4 weeks) | Excellent: 9 Good: 2 (figure of eight wires) |
No non-union or elbow OA |
| Kim et al8 | – | 10 | – | Hinged elbow brace (8 weeks). ROM exercises after 1 week | All had full ROM, 100% MEPS, and elective removal of pins under sedation at 12 weeks post-op | All had bony union with no loss of reduction or growth arrest |
| Maity et al13 | – | 7 | – | Cast for 4 weeks | Excellent in all patients, no complications Full painless range of motion within 6 months |
Excellent in all patients, no complications United within 6 weeks |
| Newell23 | – | – | 1 (soft tissue suture) | Cast for 1 month (extension) | The single operative case regained ROM 0-130 degrees by 3 months | Not stated |
| Papavasiliou et al17 | 4 | – | – | Cast for 3 weeks | All painless but with 20 degrees loss of extension | All had overgrowth of olecranon epiphysis |
| Perkins et al19 | 17 | 29 | – | Cast for 2–4 weeks | Hardware removal at 6 months (12/17 TBW, 17/29 TBS). Revision fixation at mean 23 days (1/17 TBW (plate), 4/29 TBS (1 TBW, 1 plate, 1 screw, 1 TBS). Revision group in TBS older and heavier | Union 89% (41/46) following initial surgery |
Notes. TBS, tension band suture; TBW, tension band wire; OA, osteoarthritis; Quick DASH, Disabilities of the Arm, Shoulder and Hand; ROM, range of motion; MEPS, Mayo Elbow Performance Score.