Table1.
Summary of studies reporting non-operative treatment of displaced olecranon fracture in the elderly
| Study | Number of patients | Mean age (years) | Immobilisation method (patients) | Immobilisation duration (mean days) | Mean follow-up (months) | Pain | Elbow ROM | Functional assessment/patient satisfaction | Treatment complications (number of patients) |
|---|---|---|---|---|---|---|---|---|---|
| Duckworth et al. [18] RCT |
19 11 ORIF 8 non-op |
83 (75–92) |
In non-op group Collar and cuff (4) Above elbow plaster (4) |
15 | 12 | – |
ORIF: mean arc flexion: 129° Non-op: mean arc flexion: 106° |
ORIF: Mean DASH: 22, mean MEPI: 95 Mean Broberg & Morrey: 94 (80–100) Non-op: Mean DASH: 23, mean MEPI: 95 Mean Broberg & Morrey: 88 (66–100) |
ORIF: 81.8% complications rate (11); infection (1), loss of reduction (6), further surgery (3), removal of metalwork (3) Non-op: 14.3% complications rate (1) patient crossed over to ORIF group with subsequent infection and further surgery |
| Marot et al. [22] | 21 | 88.8 (77–95) | Elbow-to-body sling-and-swathe | 14 | 6 |
VAS 1 (0–3) |
Mean ROM: Extension −15° Flexion 135° |
Mean MEPS: 95.26/100 (85–100) Mean quick DASH: 4.3(0–29.55) |
None |
| Duckworth et al. [17] | 43 | 76 (40–98) |
Above elbow plaster (28) Collar-and-cuff sling (15) |
Plaster: 28 (7–42) |
72 (24–180) |
Mild pain 2pts (9%) Mod-severe pain 1 pt (4%) |
Mean elbow flexion 126° Mean extension 18° Mean pronation 79° Mean supination 80° |
Mean DASH 2.9 (0–33.9) Mean OES 47 (42–48) Satisfaction rate 91% |
Weakness/inability to push up from a chair 17% (4) Elbow stiffness 4% (1) |
| Gallucci et al. [16] | 28 | 82 (71–91) | Above elbow plaster (28) | 5(4–7) | 16 (12–26) |
Median VAS (1.1) 2 pt during ROM 8 pts episodes of pain |
Mean ROM: Flexion 140° Extension 15° 92% compared to contralateral |
Excellent: 22 pts Good: 6 pts Mean MEPI: 95 (85–100) Mean DASH: 15.4 (0–43) Mean satisfaction:9 (8–10) |
- |
| Veras del Monte et al. [15] | 12 | 81.8 (73–90) |
Above elbow plaster (4) Splint (8) |
29 (7–84) | 15.2 (6–33) | 67% pain free |
Median ROM: Flexion 136.5° Extension-7.5° Pronation 83.5° Supination 83.5° |
Good (8 pts) Fair (3 pts) Poor (1 pt) Excellent satisfaction in 92% (11) of patients |
Skin sore (1) Degenerative arthropathy (1) |
ROM range of motion, ORIF open reduction and internal fixation, Pt patient, VAS visual analogue scale, MEPI Mean Mayo Elbow Performance Index; DASH Disability of Arm Shoulder and Hand, OES Oxford Elbow Score, MEPS Mayo Elbow Performance Score