Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.
Trial Lecture – time and place
See Trial Lecture.
Adjudication committee
- First opponent: Honorary Consultant Surgeon Simon M. Lambert, University College London Hospital, UK
- Second opponent: Associate Professor Hanna Björnsson Hallgren, Linköping University Hospital, Sweden
- Third member and chair of the evaluation committee: Professor II Sigbjørn Dimmen, University of Oslo
Chair of the Defence
Professor II Pål Aksel Næss, University of Oslo
Principal Supervisor
Senior Consultant Gunnar Birkeland Flugsrud, Oslo University Hospital
Summary
This thesis addresses knowledge gaps in the operative treatment of isolated, displaced olecranon fractures. Traditionally, simple two-part fractures have been treated with tension band wiring (TBW), while multifragmented fractures have been managed with precontoured plate fixation (PF).
In a cadaveric biomechanical model, TBW and PF demonstrated comparable fracture-retaining properties in transverse two-part fractures. A multicenter retrospective study of 800 patients revealed a high overall rate of secondary surgery (41%), particularly in younger patients and in those treated with TBW. The most common causes were symptomatic implants, hardware failure, and infection.
Finally, a randomized controlled trial including 200 patients compared TBW and PF for both two-part and multifragmented fractures. The study found no difference in functional outcomes, but secondary surgeries were more frequent in the TBW group, mainly due to removal of symptomatic hardware.
Taken together, these studies demonstrate that TBW is non-inferior to PF regarding clinical outcomes, but is associated with a higher risk of reoperation.
Additional information
Contact the research support staff.