[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-detail-449323-en":59,"doc-seo-449323-105":79},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":5,"data":60},{"doc_id":61,"user_id":62,"nickname":63,"user_avatar":64,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":66,"doc_content":67,"file_id":68,"file_url":69,"file_type":70,"file_size":71,"view_count":39,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":14,"language":72,"language_code":73,"site_id":74,"html_lang":73,"table_of_contents":75,"faqs":76,"seo_title":77,"seo_description":66,"update_tm":78,"read_time":24,"preview_page_count":4},449323,5909892115043,"Bulrr","https://ap-avatar.wpscdn.com/davatar_6f874abed73319feea01a86fa6f0fab8","Early Clinical Outcomes of Polyaxial Locking Cap Plate Fixation for Displaced Olecranon Fractures - Letter to the Editor","A letter to the editor provides critical commentary on a retrospective study evaluating polyaxial locking cap plate fixation for displaced olecranon fractures. The authors highlight promising short-term union and functional recovery, while noting study limitations including small sample size, retrospective design, lack of a control group, and incomplete follow-up. The letter compares outcomes with evidence from randomized trials using tension-band wire and plate fixation, discusses the uncertainty of long-term implant-related issues, and calls for well-designed comparative randomized studies and broader follow-up endpoints.","LETTER TO THE EDITOR  \nEarly Clinical Outcomes of Polyaxial Locking Cap Plate Fixation for Displaced Olecranon  \nFractures  \nDear Editor  \nW e read  \nClinical  \nwith great interest the article titled,“Early Outcomes of Polyaxial Locking Cap Plate  \nFixation for Displaced Olecranon Fractures” by Gutman et al.1 The authors demonstrate promising shortterm results with polyaxial locking plates, emphasizing high union rates and functional recovery. We commend their efforts to advance fixation strategies for these challenging fractures, and we offer the following commentary.  \nStudy design was retrospective (Level IV evidence) with no control group, and the sample size was relatively small (24 patients, of whom 19 had documented functional outcomes). As the authors acknowledge, a 79% follow-up rate introduces some risk of bias, and the limited cohort size hinders subgroup analysis by fracture type. The absence of a comparison group means we cannot definitively conclude that the polyaxial locking-cap plate is superior to traditional fixation methods. For instance, in a Level I randomized trial, Duckworth et al. found no significant difference in 1-year functional outcomes between TBW and conventional plate fixation for isolated olecranon fractures.2 Authors’ excellent DASH and Single Assessment Numeric Evaluation (SANE) scores at short-term follow-up are comparable to those in both the TBW and plating arms of that RCT.2 Thus, without a direct comparator, it remains unclear whether the observed outcomes reflect an advantage of the locking-cap design or the generally favorable results of olecranon ORIF when appropriately applied. Additionally, follow-up in the present study was limited to roughly 1–2 years, so potential late issues – such as implant-related irritation beyond 2 years or arthritic changes – were not captured. In prior plating studies with longer follow-up, hardware prominence symptoms often emerge over time, sometimes impacting range of motion and necessitating implant removal.3,4 Authors report zero hardware removals in the early postoperative period, but whether this low reoperation rate persists with long-term retention of the locking-cap plates is an open question.  \nLooking ahead, we agree with the authors that further investigation is warranted. In particular, randomized controlled trials (RCTs) or well-designed comparative studies should be pursued to rigorously evaluate polyaxial locking-cap plates against standard techniques. One  \npriority would be an RCT comparing the locking-cap plate to TBW in simple transverse fractures and to modern locked plating (including variable-angle designs) in comminuted fractures. Such a study could clarify if the polyaxial locking-cap construct offers any measurable improvements in union rate, elbow function, or complication profile. Key endpoints should include hardware-related complications and reoperation rates, as these differ between fixation methods in the literature. Notoriously, TBW fixation often leads to symptomatic hardware requiring removal – reported in roughly 30–50% of cases in active patients.2,5 Plating tends to reduce this problem, but not eliminate it: for example, Duckworth’s trial 2 saw a 22% implant removal rate for plates at 1 year, and other series report plate removal in up to 40% of patients over longer follow-up.4 In Authors’ study, the 0% hardware removal rate at 2 years is a promising signal that the locking-cap design might mitigate irritation. However, only with larger numbers and extended surveillance can we determine if this implant truly allows improved hardware retention compared to conventional approaches. We also suggest tracking outcomes beyond union, such as subtle losses of motion or patient-reported elbow scores at more than 5 years, to ensure that excellent early outcomes translate into durable long-term success.  \nAcknowledgement  \nN/A  \nAuthors Contribution: Kang QIN wrote the paper. Liang ZHAO andYijun WANG revised the manuscript. Decl","cbCaijwrQ4iaeatL","https://ap.wps.com/l/cbCaijwrQ4iaeatL","pdf",444754,"English","en",105,"# Letter to the Editor\n## Study Design and Key Limitations\n## Comparison With Randomized Evidence\n## Need for Further Research\n## Authors’ Declarations and Contributions\n## References","[{\"question\":\"What evidence does the letter cite to question the study’s conclusions?\",\"answer\":\"It notes the retrospective Level IV design without a control group, a small cohort, and risk of bias from incomplete follow-up. It also explains that without direct comparison, superiority over traditional fixation cannot be concluded.\"},{\"question\":\"How does the letter compare short-term functional outcomes across fixation methods?\",\"answer\":\"It states that the reported DASH and SANE scores are comparable to outcomes in randomized or comparative evidence involving tension-band wiring and conventional plating arms. This suggests similar short-term function despite different fixation strategies.\"},{\"question\":\"Why does the letter emphasize long-term follow-up?\",\"answer\":\"The letter argues that late complications—such as implant irritation and arthritic changes—may appear beyond the study’s roughly 1–2 year follow-up. It also discusses that hardware prominence symptoms often emerge over time in other plating studies.\"},{\"question\":\"What future study does the letter recommend?\",\"answer\":\"It recommends randomized controlled trials comparing the locking-cap plate against TBW for simple transverse fractures and against modern locked plating (including variable-angle designs) for comminuted fractures, using endpoints like hardware complications and reoperation rates.\"}]","Early Clinical Outcomes of Polyaxial Locking Cap Plate Fixation for Displaced Olecranon Fractures - Letter to the Editor | PDF",1790729873,{"code":4,"msg":80,"data":81},"ok",{"site_id":74,"language":73,"slug":82,"title":65,"keywords":83,"description":66,"schema_data":84,"social_meta":142,"head_meta":144,"extra_data":146,"updated_unix":147},"early-clinical-outcomes-of-polyaxial-locking-cap-plate-fixation-for-displaced-olecranon-fractures-letter-to-the-editor","",{"@graph":85,"@context":141},[86,100,120],{"@type":87,"itemListElement":88},"BreadcrumbList",[89,93,95,98],{"item":90,"name":91,"@type":92,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":94,"name":9,"@type":92,"position":14},"https://docshare.wps.com/document/",{"item":96,"name":35,"@type":92,"position":97},"https://docshare.wps.com/document/healthcare/",3,{"item":99,"name":65,"@type":92,"position":19},"https://docshare.wps.com/document/early-clinical-outcomes-of-polyaxial-locking-cap-plate-fixation-for-displaced-olecranon-fractures-letter-to-the-editor/449323/",{"url":99,"name":65,"@type":101,"image":102,"author":107,"headline":65,"publisher":109,"fileFormat":112,"inLanguage":73,"description":66,"dateModified":113,"datePublished":114,"encodingFormat":112,"isAccessibleForFree":115,"interactionStatistic":116},"DigitalDocument",{"url":103,"@type":104,"width":105,"height":106},"https://docshare.wps.com/thumbnails/early-clinical-outcomes-of-polyaxial-locking-cap-plate-fixation-for-displaced-olecranon-fractures-letter-to-the-editor/449323.png","ImageObject",300,407,{"name":63,"@type":108},"Person",{"url":90,"name":110,"@type":111},"DocShare","Organization","application/pdf","2026-11-03","2026-09-30",true,{"@type":117,"interactionType":118,"userInteractionCount":39},"InteractionCounter",{"@type":119},"ViewAction",{"@type":121,"mainEntity":122},"FAQPage",[123,129,133,137],{"name":124,"@type":125,"acceptedAnswer":126},"What evidence does the letter cite to question the study’s conclusions?","Question",{"text":127,"@type":128},"It notes the retrospective Level IV design without a control group, a small cohort, and risk of bias from incomplete follow-up. It also explains that without direct comparison, superiority over traditional fixation cannot be concluded.","Answer",{"name":130,"@type":125,"acceptedAnswer":131},"How does the letter compare short-term functional outcomes across fixation methods?",{"text":132,"@type":128},"It states that the reported DASH and SANE scores are comparable to outcomes in randomized or comparative evidence involving tension-band wiring and conventional plating arms. This suggests similar short-term function despite different fixation strategies.",{"name":134,"@type":125,"acceptedAnswer":135},"Why does the letter emphasize long-term follow-up?",{"text":136,"@type":128},"The letter argues that late complications—such as implant irritation and arthritic changes—may appear beyond the study’s roughly 1–2 year follow-up. It also discusses that hardware prominence symptoms often emerge over time in other plating studies.",{"name":138,"@type":125,"acceptedAnswer":139},"What future study does the letter recommend?",{"text":140,"@type":128},"It recommends randomized controlled trials comparing the locking-cap plate against TBW for simple transverse fractures and against modern locked plating (including variable-angle designs) for comminuted fractures, using endpoints like hardware complications and reoperation rates.","https://schema.org",{"og:url":99,"og:type":143,"og:title":65,"og:site_name":110,"og:description":66},"article",{"robots":145,"canonical":99},"index,follow",{"doc_id":61,"site_id":74},1790815191]