Critical analysis of XXXX management by pre-contoured locking plates.

@entity1 @entity571 @entity174 @entity8213 @entity196 @entity281 @entity2444
BACKGROUND: Fractures of the proximal ulna are rare and usually managed surgically. Strong fixation of the harware is essential to obtain good outcomes. We report our experience with pre-contoured locking plate fixation of complex olecranon @entity174 and present a critical appraisal of the outcomes. HYPOTHESIS: Pre-contoured locking plates provide good outcomes, but their clinical tolerance may be limited in some instances. MATERIALS AND METHODS: From September 2009 to December 2011, 28 @entity1 were managed using a pre-contoured locking compression plate ( @entity2444 (  )). Among them, 6 were excluded because of missing data, which left 22 @entity1 (11 males and 11 females) with a mean age of 55.7 years, including 12 who were employed. The @entity174 was on the dominant side in 11 @entity1 . According to the Mayo Clinic classification, 15 @entity174 were @entity196 . In addition to the ulnar @entity174 , a @entity174 was present in 9 @entity1 and a @entity174 in 5 @entity1 . Functional recovery was assessed using the Broberg-Morrey score and Mayo Elbow Performance Score (MEPS). Radiographs were obtained to evaluate the quality of @entity174 reduction and @entity174 healing, as well as to look for ossifications and @entity571 . RESULTS: Mean follow-up was 20 months. Flexion was 131  , extension loss was 9.5  , pronation was 79  , and supination was 80.5  . The mean Broberg-Morrey score was 96.7 and the mean MEPS score 96.6. @entity174 healing occurred in all @entity1 , within a mean of 10.6 weeks. Evidence of early @entity571 was found in 6 @entity1 , ossifications in 3 @entity1 , and @entity8213 in 1 @entity1 . An @entity281 was successfully treated with lavage and antibiotic therapy in 1 @entity1 . The fixation hardware was removed in 6 @entity1 . No prognostic factors were identified. DISCUSSION-CONCLUSION: Our hypothesis was confirmed. The outcomes are encouraging and comparable to those reported in the literature. The critical issue is the limited clinical tolerance of the plate with a high rate of posterior impingement requiring plate removal (27%). Rigorous technique is essential during plate implantation. LEVEL OF EVIDENCE: Level IV, retrospective study.
