FRACTURES OF THE OLECRANON

¹ The Fracture Service of the Massachusetts General Hospital

1. A statistical study is made of forty-eight cases of fracture of the olecranon with end-result studies in twenty-four. Fifteen of these cases were treated in the Emergency Ward and were not admitted to the House.

2. Closed reduction of these fractures has been very unsatisfactory and we believe that it is not worth attempting. Open operation is indicated whenever there is any separation of the bone fragments.

3. The results of open operation by any one of five methods have been universally satisfactory. The only unsatisfactory cases have been one complicated by postoperative sepsis and another complicated by an ill-advised secondary operation done elsewhere. The operation calls for exact reposition of the fragments and fixation by catgut, wire, kangaroo tendon, nails, pegs, or fascia lata. The use of foreign bodies as fixatives means secondary operations for their removal.

4. The operative mortality was four and three-tenths per cent. in the twenty-three cases on whom open operations were done.

5. There is no relation between the age groups or the degree of development of the epiphysis and the final result.

6. From our tabulated results it is not possible to demonstrate any quicker recovery from the use of any one material, but from personal observation we are convinced that function returns faster and the final elbow is stronger when fascia lata is used as a living suture to hold the fragments together. This is the method now in use at this hospital and the method which we wish to recommend.

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