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Geriatric olecranon fractures treated with plate fixation have low complication rates

Background: A recent randomized controlled trial compared operative with nonoperative treatment of olecranon fractures in patients 75 yr and older. The study was notable for high complication rates, and operative treatment was cautioned against. The purpose of this study was to determine the complication rate among geriatric patients with an olecranon fracture treated surgically with plate fixation. Methods: The records of patients 75 yr and older treated with plate fixation for an olecranon fracture at a single level I trauma center were reviewed. Variables recorded included basic demographic data, complications, need for reoperation, and union at final follow-up. Results: Thirty-six patients met inclusion criteria, with a mean follow-up of 10 mo. Thirty-four of the 36 patients went on to union successfully prior to any subsequent surgery (94%). The overall reoperation rate was 11% (4 of 36 patients). Conclusions: The complication and reoperation rates after plate fixation of geriatric olecranon fractures were low. Loss of reduction was uncommon, and most patients went on to uneventful fracture union. These results support plate fixation of olecranon fractures in geriatric patients as a viable alternative to nonoperative management.