American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2017, 5(6), 166-170
DOI: 10.12691/ajmcr-5-6-9
Open AccessArticle

Triceps Aponeurosis Tongue Shape Flap: A New Technique to Solve the Wound Problem in Olecranon Fracture Fixation

Mohamad Qoreishy1, Ali Keipourfard1, , Alireza Manafi Rasi2, Ali Tahririan3 and Mehran Soleyman Ha4

1Bone Joint and Related Tissue Research Center, Akhtar Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

2Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran

3Isfahan University of Medical Sciences

4Guilan University of Medical Sciences

Pub. Date: July 15, 2017

Cite this paper:
Mohamad Qoreishy, Ali Keipourfard, Alireza Manafi Rasi, Ali Tahririan and Mehran Soleyman Ha. Triceps Aponeurosis Tongue Shape Flap: A New Technique to Solve the Wound Problem in Olecranon Fracture Fixation. American Journal of Medical Case Reports. 2017; 5(6):166-170. doi: 10.12691/ajmcr-5-6-9

Abstract

Background: Internal fixations for olecranon fractures, like tension band wiring and plates, have some complications such as prominence of the devices, neurovascular injuries, superficial infection, and skin irritation. In this study, a new triceps aponeurosis tongue shape flap technique was used to solve the problem in patients with olecranon fracture fixation. Materials and methods: Nine patients with olecranon fractures were evaluated. After fixation by tension band wiring and plate, the free aponeurosis triceps muscle in a tongue-shaped flap was used and rotated 180° to cover the whole the pin wire or plate. The surgeon then began to suture it to the anconeus, extensor carpi ulnaris and flexor carpi ulnaris muscles, fully around, with absorbable sutures. The follow-up time was eight weeks and a Mayo elbow performance score (MEPS) was filled for all patients. Results: Nine patients were analysed. Two cases were male and seven was female. The meanage was 49.11±10.37 years. Extension was full in six patients and was 170 in three. Flexion was full in all patients. No complications were recorded. The MEPS results showed that it was good and excellent in all the patients (number for patients was in the range of 80-95). Conclusion: According to results of present study, this technique can help to surgical fixation of olecranon fractures with different devices to have fewer complications, especially prominence of fixator systems and with this method tension band wiring can be remained as a gold standard in olecranon fracture fixation.

Keywords:
olecranon fracture internal fixation triceps aponeurosis flap

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References:

[1]  Schneider, M.M., Nowak, T.E., Bastian, L., Katthagen, J.C., Isenberg, J., Rommens, P.M., Müller, L.P., Burkhart, K.J., “Tension band wiring in olecranon fractures: the myth of technical simplicity and osteosynthetical perfection,” International orthopaedics, 38(4):847-55. 2014.
 
[2]  Snoddy, M.C., Lang, M.F., An, T.J., Mitchell, P.M., Grantham, W.J., Hooe, B.S., Kay, H.F., Bhatia, R., Thakore, R.V., Evans, J.M., Obremskey, W.T., “Olecranon fractures: factors influencing re-operation,” International orthopaedics, 38(8):1711-6. 2014.
 
[3]  Hak. D.J., Golladay, G.J., “Olecranon fractures: treatment options,” J Am Acad Orthop Surg, 8(4):266-75. 2000.
 
[4]  Newman, S., Mauffrey, C., Krikler, S., “Olecranon fractures,” Injury, 40(6):575-81. 2009.
 
[5]  Mullett, J., Shannon, F., Nöel, J., Lawlor, G., Lee, T., O’Rourke, S., “K-wire position in tension band wiring of the olecranon-a comparison of two techniques,” Injury, 31(6): 427-31. 2000.
 
[6]  Murphy, D.F., Greene, W.B., Dameron, T.B., “Displaced olecranon fractures in adults: clinical evaluation,” Clin Orthop Relat Res, 224:215-23. 1987.
 
[7]  Molloy, S., Jasper, L.E., Elliott, D.S., Brumback, R.J., Belkoff, S.M., “Biomechanical evaluation of intramedullary nail versus tension band fixation for transverse olecranon fractures,” J Orthop Trauma, 18(3):170-4. 2004.
 
[8]  Nikouei, A., Seddighi, A., Seddighi, A.S., “The Results of Image Guided Surgery Using Neuronavigation in Resection of Cerebral Gliomas in Eloquent Cortical Areas,” Archives of Physical Medicine and Rehabilitation, 97(10):e69-70. 2016.
 
[9]  Hamilton Jr, D.A., Reilly, D., Wipf, F., Kamineni, S., “Comminuted olecranon fracture fixation with pre-contoured plate: Comparison of composite and cadaver bones,” World J Orthop, 6(9): 705. 2015.
 
[10]  Donegan, R.P., Bell, J.E., “Olecranon fractures,” Oper Tech Orthop, 20(1):17-23. 2010.
 
[11]  Macko, D., Szabo, R.M., “Complications of tension-band wiring of olecranon fractures,” J Bone Joint Surg Am, 67(9): 1396-401. 1985.
 
[12]  Wilkerson, J.A., Rosenwasser, M.P., “Surgical techniques of olecranon fractures,” J Hand Surg Am, 39(8):1606-14. 2014.
 
[13]  Bailey, C.S., MacDermid, J., Patterson, S.D., King, G.J., “Outcome of plate fixation of olecranon fractures,” J Orthop Trauma, 15(8):542-8. 2001.
 
[14]  Veillette, C.J.H., Steinmann, S.P., “Olecranon Fractures,” Orthop Clin North Am, 39(2):229-36. 2008.
 
[15]  Hume, M.C., Wiss, D.A., “A clinical and radiographic comparison of tension band wiring and plate fixation,” Clin Orthop Relat Res, 285:229-35. 1992.
 
[16]  Seddighi, A., Seddighi, A.S., Nikouei, A., Ashrafi, F., Nohesara, S., “Psychological aspects in brain tumor patients: A prospective study,” Hell J Nucl Med, 18 Suppl 1:63-7. 2015.
 
[17]  Nilsson-Helander, K., Swärd, L., Silbernagel, K.G., Thomeé, R., Eriksson, B.I., Karlsson, J., “A new surgical method to treat chronic ruptures and reruptures of the Achilles tendon,” Knee Surg Sports Traumatol Arthrosc, 16(6):614-20. 2008.
 
[18]  Jeng, S.F., “Free composite groin flap and vascularized external oblique aponeurosis for traumatic avulsion injuries of the foot,” J Trauma, 35(1): 71-4. 1993.
 
[19]  Eck, D.L., Koonce, S.L., Al Majed, B.M., Perdikis, G., “Evaluation of options for large scalp defect reconstruction: a 12-year experience,” Eplasty, 14. 2014.
 
[20]  Villanueva, P., Osorio, F., Commessatti, M., Sanchez-Sotelo, J., “Tension-band wiring for olecranon fractures: analysis of risk factors for failure,” J Shoulder Elbow Surg, 15(3):351-6. 2006.
 
[21]  Wiegand, L., Bernstein, J., Ahn, J., “Fractures in brief: Olecranon fractures,” Clin Orthop Relat Res, 1-5. 2012.
 
[22]  Jones, T.B., Karenz, A.R., Weinhold, P.S., Dahners, L.E., “Transcortical Screw Fixation of the Olecranon Shows Equivalent Strength and Improved Stability Compared With Tension Band Fixation,” J Orthop Trauma, 28(3):137-42. 2014.
 
[23]  Mauffrey, C.P., Krikler, S., “Surgical techniques: How I do it? Open reduction and tension band wiring of olecranon fractures,” Injury, 40(4):461-5. 2009.
 
[24]  Rommens, P.M., Küchle, R., Schneider, R.U., Reuter, M., “Olecranon fractures in adults: factors influencing outcome,” Injury, 35(11): 1149-57. 2004.
 
[25]  Larsen, E., Jensen, C.M., “Tension-band wiring of olecranon fractures with nonsliding pins: report of 20 cases,” Acta Orthop Scand, 62(4):360-2. 1991.
 
[26]  Rommens, P.M., Schneider, R.U., Reuter, M., “Functional results after operative treatment of olecranon fractures,” Acta Chir Belg, 104(2):191-7. 2004.
 
[27]  Saeed, Z.M., Trickett, R.W., Yewlett, A.D., Matthews, T.J., “Factors influencing K-wire migration in tension-band wiring of olecranon fractures,” J Shoulder Elbow Surg, 23(8):1181-6. 2014.
 
[28]  Joshi, R.P., “The Hastings experience of the Attenborough springs and Rush nail for fixation of olecranon fractures,” Injury, 28(7): 455-8. 1997.
 
[29]  Macko, D.O., Szabo, R.M., “Complications of tension-band wiring of olecranon fractures,” J Bone Joint Surg Am, 67(9): 1396-401. 1985.
 
[30]  Morrey, B.F., “Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid,” J Bone Joint Surg Am, 77(2):316-27. 1995.
 
[31]  Nowinski, R.J., Nork, S.E., Segina, D.N., Benirschke, S.K., “Comminuted fracture-dislocations of the elbow treated with an AO wrist fusion plate,” Clin Orthop Relat Res, 378:238-44. 2000.
 
[32]  Chan, K.W., Donnelly, K.J., “Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate?,” J Orthop, 12(2):111-7. 2015.
 
[33]  Prayson, M.J., Iossi, M.F., Buchalter, D., Vogt, M., Towers, J., “Safe zone for anterior cortical perforation of the ulna during tension-band wire fixation: a magnetic resonance imaging analysis,” J Shoulder Elbow Surg, 17(1):121-5. 2008.
 
[34]  Parker, J.R., Conroy, J., Campbell, D.A., “Anterior interosseus nerve injury following tension band wiring of the olecranon,” Injury, 36(10):1252-3. 2005.
 
[35]  Catalano, L.W., Crivello, K., Lafer, M.P., Chia, B., Barron, O.A., Glickel, S.Z., “Potential dangers of tension band wiring of olecranon fractures: an anatomic study,” J Hand Surg, 36(10): 1659-62. 2011.
 
[36]  Candal-Couto, J.J., Williams, J.R., Sanderson, P.L., “Impaired forearm rotation after tension-band-wiring fixation of olecranon fractures: evaluation of the transcortical K-wire technique,” J Orthop Trauma, 19(7):480-2. 2005.
 
[37]  Matthews, F., Trentz, O., Jacob, A.L., Kikinis, R., Jupiter, J.B., Messmer, P., “Protrusion of hardware impairs forearm rotation after olecranon fixation,” J Bone Joint Surg Am, 89(3): 638-42. 2007.