Olecranon fractures in children affected by osteogenesis imperfecta

Displaced isolated olecranon fractures are rare in pae- diatric population, but they may occur more often in children affected by osteogenesis imperfecta (OI). The aim of this study is to compare the outcome of two different techniques, the tension-band wiring (TBW) and the screw fixation, in olecranon fractures in children with OI. Methods Between 2006 and 2013, 22 isolated olecranon fractures were surgically treated in 18 children affected by OI. The mean age at time of injury was 12 years. All the patients had OI at the time of the injury (10 type I, 5 type III, and 3 type IV). A bilateral fracture occurred in four patients. Mechanism of injury included avulsion fracture in 14 cases, direct blow in 6 cases, and indirect trauma in 2 cases. The fractures were classified according to Mayo classification. The surgical technique adopted was a tension-band wiring in 10 cases, and a screw fixation in 10 cases. The other two composed fractures were treated through cast immobilization. The average follow-up time was 2.5 years. Range of motion, elbow’s axial alignment, muscle strength and joint stability were estimated. POSNA questionnaire was used. Radiographic evaluation was performed focusing on bone healing. Radiographic follow-up was based on post-operative radio- graphs, X-rays performed 3 weeks, 4 and 12 months after treatment. Clinical follow-up was after 2, 3, 6 weeks, 4 and 12 months after treatment.