{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T09:42:10Z","timestamp":1768815730202,"version":"3.49.0"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"1","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To determine the effect of intramedullary screw\u2013based fixation on early postoperative complications after olecranon fractures. We hypothesized that intramedullary screw\u2013based fixation results in decreased need for reoperation compared with plate and screw\u2013based and tension band\u2013based fixation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Design:<\/jats:title>\n            <jats:p>Retrospective cohort.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Setting:<\/jats:title>\n            <jats:p>Two academic Level-1 trauma centers.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Patients\/Participants:<\/jats:title>\n            <jats:p>Five hundred fifty-six patients treated with a tension band\u2013based, plate and screw\u2013based, or intramedullary screw\u2013based construct for an olecranon fracture over a 10-year period.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Intervention:<\/jats:title>\n            <jats:p>Open reduction and internal fixation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Main Outcome Measurement:<\/jats:title>\n            <jats:p>Unplanned reoperation. Demographic, injury type and severity, supplemental fixation, and length of follow-up data were viewed as potential confounders and analyzed as such.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>We identified 556 relevant patients. One hundred ninety-nine patients were treated with an intramedullary screw\u2013based construct, 229 with a plate and screw\u2013based construct, and 128 with a tension band\u2013based construct. We observed significant differences in the age, fracture type, percentage of open fractures, use of supplemental fixation, and treating institution between the treatment groups. Ninety-five patients (17.1%) had an unplanned reoperation. When we adjusted for confounders, intramedullary screw\u2013based fixation reduced the odds of an unplanned reoperation by 54% compared with plate and screw\u2013based treatment. In the adjusted analysis, we did not observe a difference between plate and screw\u2013based treatment and tension band\u2013based fixation.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Intramedullary screw\u2013based fixation of olecranon fractures results in decreased need for early reoperation compared with more common olecranon fixation strategies.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Level of Evidence:<\/jats:title>\n            <jats:p>Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/bot.0000000000002145","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T13:08:57Z","timestamp":1619010537000},"page":"e24-e29","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":11,"title":["Intramedullary Screw Fixation of Olecranon Fractures Reduces the Risk of Early Unplanned Reoperation: A Retrospective Review of 556 Patients"],"prefix":"10.1097","volume":"36","author":[{"given":"Clifton","family":"Meals","sequence":"first","affiliation":[{"name":"Department of Orthopedics, Emory University School of Medicine, Atlanta, GA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Johnson","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, Emory University School of Medicine, Atlanta, GA;"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Logan","family":"Reitz","sequence":"additional","affiliation":[{"name":"Morehouse University School of Medicine, Atlanta, GA; and"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zachary","family":"Hannan","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Mulliken","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nathan N.","family":"O'Hara","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond","family":"Pensy","sequence":"additional","affiliation":[{"name":"Department of Orthopedics, University of Maryland School of Medicine, Baltimore, MD."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R1-20250614","doi-asserted-by":"crossref","first-page":"S1","DOI":"10.1097\/BOT.0000000000001063","article-title":"Fracture and dislocation classification compendium-2018","volume":"32","author":"Meinberg","year":"2020","journal-title":"J Orthop Trauma."},{"key":"R2-20250614","doi-asserted-by":"crossref","first-page":"964","DOI":"10.1302\/0301-620X.99B7.BJJ-2016-1112.R2","article-title":"Prospective randomised trial of non-operative versus operative management of olecranon fractures in the elderly","volume":"99-B","author":"Duckworth","year":"2017","journal-title":"Bone Joint J."},{"key":"R3-20250614","doi-asserted-by":"crossref","first-page":"67","DOI":"10.2106\/JBJS.L.01137","article-title":"Nonoperative management of displaced olecranon fractures in low-demand elderly patients","volume":"96","author":"Duckworth","year":"2014","journal-title":"J Bone Joint Surg Am."},{"key":"R4-20250614","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1097\/BOT.0000000000000152","article-title":"Treatment of olecranon fractures with 2.4- and 2.7-mm plating techniques","volume":"29","author":"Wellman","year":"2015","journal-title":"J Orthop Trauma."},{"key":"R5-20250614","doi-asserted-by":"crossref","first-page":"1261","DOI":"10.2106\/JBJS.16.00773","article-title":"plate versus tension-band wire fixation for olecranon fractures: a prospective randomized trial","volume":"99","author":"Duckworth","year":"2017","journal-title":"J Bone Joint Surg Am."},{"key":"R6-20250614","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1097\/BOT.0000000000001139","article-title":"What is the ideal starting point for an olecranon screw? 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