Primary Total Elbow Replacement for Treatment of Complex Distal Humerus Fracture: Outcomes of Short-term Follow-up

Implant survival of total elbow arthroplasty: analysis of 514 cases from the Dutch Arthroplasty Registry

The aim of this study is to report the implant survival and factors associated with revision of total elbow arthroplasty (TEA) using data from the Dutch national registry. All TEAs recorded in the Dutch national registry between 2014 and 2020 were included. The Kaplan-Meier method was used for survival analysis, and a logistic regression model was used to assess the factors associated with revision. A total of 514 TEAs were included, of which 35 were revised. The five-year implant survival was 91%. Male sex, a higher BMI, and previous surgery to the same elbow showed a statistically significant association with revision (p < 0.036). Of the 35 revised implants, ten (29%) underwent a second revision. This study reports a five-year implant survival of TEA of 91%. Patient factors associated with revision are defined and can be used to optimize informed consent and shared decision-making. There was a high rate of secondary revisions.

Comparative Analysis of Clinical Effects of the Cable-Pin System and Kirschner Wire Tension Band (TBW) Internal Fixation in the Treatment of the Olecranon Fracture

Objective

To explore the clinical effects of the cable-pin system and Kirschner wire tension band (TBW) internal fixation in the treatment of the olecranon fracture.

Methods

Fifty patients with an olecranon fracture were treated in our hospital from April 2018 to March 2020. Patients were randomly divided into control and study groups. The control group was fixed with TBW, and the study group was fixed with the cable-pin system. The operation, the circumference difference between the injured limb and the healthy limb, the VAS score, the excellent and good rate, the recovery of the range of motion of the joint 1 year after operation, and the incidence of postoperative adverse reactions were compared between the two groups.

Results

In terms of the operation of the two groups, the operation time, intraoperative blood loss, healing time, incision drainage, and hospital stay in the study group were lower than those in the control group (P < 0.05). In the comparison of the circumference difference between the injured limb and the healthy limb, there was no significant difference between the two groups before operation (P > 0.05), but the circumference difference between the injured limb and the healthy limb in the study group was lower than that in the control group at 24 hours, 72 hours, 7 days, and 30 days after operation, and the difference was statistically significant (P < 0.05). There was no significant difference in the VAS score between the two groups before operation, but 7-day VAS scores at 12 h, 24 h, and 72 h after operation in the study group were significantly lower than those in the control group (P < 0.05). The excellent and good rate in the study group was excellent in 18 cases, good in 5 cases, fair in 2 cases, excellent in 7 cases, good in 6 cases, fair in 8 cases, and poor in 4 cases in the control group, and the excellent and good rate in the study group (100.00%) was higher than that in the control group (84.00%), and the difference was statistically significant (P < 0.05). The patients in the two groups were followed-up for one year, and there were no shedding cases in the two groups. In terms of the recovery of range of motion one year after operation, the scores of elbow flexion, extension/degree, and elbow function in the study group were higher than those in the control group (P < 0.05), and the difference was statistically significant (P < 0.05). The incidence of postoperative adverse reactions in the study group (4.00%) was significantly lower than that in the control group (28.00%), and the difference was statistically significant (P < 0.05). The incidence of postoperative adverse reactions was significantly lower in the study group (4.00%) than that in the control group (28.00%), and the difference was statistically significant (P < 0.05), while only 1 patient in the study group had chronic pain, while 7 patients in the control group had incision ulcer (1 case), chronic pain (2 cases), and internal fixation loosening (4 cases). The difference was statistically significant (P < 0.05).

Conclusion

The cable-pin system for the treatment of an olecranon fracture has the advantages of simple operation, fast fracture healing time, and low incidence of complications, which is a kind of orthopedic internal fixation consumable material in line with biomechanical requirements of the human body.