Risk Factors for Hardware Related Complications After Olecranon Fracture Fixation

Abstract

Objectives: The aim of this study is to evaluate risk factors for symptomatic hardware and removal of hardware (ROH) after olecranon open reduction and internal fixation (ORIF) and to assess differences between olecranon locking plate and screws (P&S) or tension band (TB) wire cohorts. Study Design: Retrospective cohort Setting: Academic Level I Trauma Center Patients/Participants: The medical records of 331 patients with olecranon fractures treated with ORIF from 2012-2016 were reviewed. After exclusions, 189 patients were included in the study. Intervention: ORIF of olecranon fractures using either plate and screw fixation or tension band fixation. Main Outcome Measures: Complications, ROH and subsequent surgery were assessed and compared between cohorts. Results: There were 124 cases in the P&S cohort, and 65 in the TB cohort. The overall reoperation rate was 31.2% (59/189). The overall incidence of ROH for all cases was 29.1% (55/189). Patients who required ROH or developed symptomatic hardware were significantly younger than those who did not (P&S p<0.003; TB p<0.004). Age and BMI were associated with ROH + symptomatic hardware after P&S. Age (but not BMI) was associated with ROH / symptomatic hardware after TB. Measured hardware prominence was not associated with ROH or ROH + symptomatic hardware for either P&S or TB cohorts.