Suture anchor fixation of displaced olecranon fractures in the elderly: a case series and surgical technique

Background: Olecranon fractures are common in elderly patients, causing significant morbidity and functional impairment. Traditional surgical treatments are often complicated by hardware failure and prominence, frequently requiring reoperation. To address these concerns, a suture anchor fixation technique was developed and clinically evaluated. Methods: A consecutive series of elderly patients treated with this technique from 2006 to 2013 at a single institution were studied. All cases were surgically repaired with nonmetallic fully threaded suture anchors in a double-row fashion. Clinical outcome measures including the shortened Disabilities of the Arm, Shoulder, and Hand score, the Oxford Elbow Score, and the 12-Item Short Form Health Survey score were obtained. Results: Eight female patients with Mayo IIA or IIB fractures were identified. The mean age of the patients at time of operation was 73.5 +/- 10.7 years (range, 59.3-88.8 years). The average time from injury to operation was 5.7 +/- 3.7 days. The average follow-up was 5.1 +/- 2.5 years (range, 0.8-7.4 years). Six patients were available for long-term follow-up; 1 patient had died, and 1 patient was unable to be contacted despite multiple attempts. There were no intraoperative complications or reoperations. All 8 patients healed uneventfully in an acceptable position without displacement. Postoperatively, the average Oxford Elbow Score was 47.17 +/- 2.04; the average shortened Disabilities of the Arm, Shoulder, and Hand score was 6.43 +/- 9.47; and the average 12-Item Short Form Health Survey scores were 49.02 +/- 16.59 and 55.38 +/- 4.05 for the physical and mental component scales, respectively. Conclusion: Suture anchor fixation of olecranon fractures in the elderly population provides excellent long-term radiographic and clinical outcomes without hardware complications associated with traditional fixation methods. Level of evidence: Level IV, Case Series, Treatment Study. (C) 2015 Journal of Shoulder and Elbow Surgery Board of Trustees.