Paediatric olecranon fractures: a systematic review

The optimal management and long-term outcomes of elect-anon fractures in the paediatric population is not well understood. This systematic review aims to analyse the literature on the Management of paediatric olecranon fractures and the long-term implications. A systematic drview of several databases was conducted according to PRISMA guidelines, English -language studies evaluating the management of isolated paediatric olecranon fractures were included. Data extracted included demographics, classifications, conservative and operative treatment methods and outcomes, Fifteen articles fitting the inclusion criteria were included. There were 11 Case series and four retrospective comparddye series. The reported studies included 299 fractures in 280 patients. The mechanism of injury 1,V d S predominantly low emergy. Fractures displaced < 4 mm were treated nonroperatively with almost universally good results, with the majority being treated with cast immobilization, Fractures displaced >4 mm were commomly treated operatively with generally good results; with tension band wire and suture fixation being the most common treatment morialities. Weight > 50 kg was associated with failure of suture fixiation. In those studies that reported olecranon fractures with associated elbow injures (e.g. radial head fractures) outcomes were poorer. Forty-six fractures were in patients,with osteorjenesis imperfecta, who sustained a higher rate of re-fracture after removal of metalwork and contralateral olecranon fracture. Despite a relatively low evidence base pool of studies, the aggregate data support the non-operative treatment of isolated undisplaced olecranon fractures with good results, and support the operative treatment of fractures displaced 4 mm.