Olecranon Fracture
Conditions
Keywords
Olecranon fracture, surgical treatment, locked plate fixation, tension band wiring
Brief summary
The incidence of the olecranon fracture (OF) in adults is around 12 per 100,000 inhabitants per year.1 The anatomical shape of the proximal ulna is largely responsible for the stabilization of the humeroulnar joint and reconstruction is therefore obligatory, but often challenging. Surgical treatment of the olecranon fracture is performed using tension band wiring (TBW) or locking plate fixation (LPF) osteosynthesis. It is not yet clear, which procedure is superior for a specific patient. In future, an individualized and objectified assessment of expected general and fracture-specific complications should enable the treatment to be individually adapted to the patient's risk profile. This shall prevent complications, unnecessary treatments, and treatment costs. In the project presented here, the reality of care for surgically treated patients with olecranon fractures will be analyzed using routine data collected by the BARMER health insurance fund. The aim of the study is to analyze differences in the outcome of patients with an olecranon fracture treated with TBW compared to LPF and to identify independent risk factors for unfavorable course.
Interventions
PROCEDURESimple fracture Tension band wiring
OPS 5-793.27
PROCEDURESimple fracture locked plate fixation
OPS 5-793.k7
PROCEDUREMulti-fragmented tension band wiring
OPS 5-794.17
PROCEDUREMulti-fragmented locked plate fixation
OPS 5-794.k7
Sponsors
Universität Münster
University Hospital Muenster
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Inpatient coded diagnosis of olecranon fracture (ICD S52.01)
Exclusion criteria
* Incomplete basic information * Incomplete insurance status within two years before index * Previous treatment of olecranon fracture * Unclear treatment of olecranon fracture * Age < 18 years * Coded polytrauma * Bone tumors/ bone metastasis * Both sides injured or missing information of surgery side
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Revision | up to 5 years | Time from surgery to revision defined above. |
| Implant removal (only) | up to 5 years | * Time from surgery to implant removal * Within first 3 months after surgery, an implant removal will also considered as a surgical complication * No SC is allowed to occur within 3 months and on the same day |
| Surgical complications (surgical complications) | up to 5 years | Time from surgery of olecranon fracture to surgical complications, with death being considered as a competing risk event. |
| In-hospital surgical complication rate (IH-SC) | through hospital stay, an average of 10 days | surgical complication after surgery during index hospitalization (yes/no) |
| In-hospital implant-associated complications (IH-IAC) | through hospital stay, an average of 10 days | In-hospital implant-associated complications after surgery during index hospitalization |
| In-hospital non-implant associated complications (IH-non-IAC) | through hospital stay, an average of 10 days | Non-in-hospital implant-associated complications after surgery during index hospitalizationi |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Overall survival (OS) | up to 5 years | * Time from surgery to death of any cause. * Death will be determined using the coded death as the reason for withdrawal in the BARMER database. In addition, all inpatient cases will be reviewed during follow-up, to determine whether death was reported as the reason for discharge. |
| Charges during index | an average of 10 days | Sum of charges of all cases of the index case series |
| 30-day mortality | 30 days | * Death from any cause within first day after surgery (yes/no) * All patients with shorter follow-up time are excluded |
| Major adverse events (MAE) | up to 5 years | Time from surgery to resuscitation, cardiac arrest, myocardial infarction, stroke, acute renal failure, acute liver failure, acute respiratory distress syndrome, sepsis or death from any case. |
| Thromboembolic events | up to five years | Time from surgery to a thromboembolic event or death of any cause. |
| Minor outpatient complication | up to five years | Time from discharge to minor outpatient complications, with death being considered as a competing risk event. |
| Length of hospital stay during index | an average of 10 days | Days of hospitalization (from admission to last discharge with index case series) |
Outcome results
None listed