Complex proximal ulna fractures: outcomes of surgical treatment

Melamed, Eitan; Danna, Natalie R.; Debkowska, Monika; Karia, Raj; Liporace, Frank A.; Capo, John T.

doi:10.1007/s00590-015-1628-z

Cited by 13 publications

(4 citation statements)

References 18 publications

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“…Our review of the literature on operative fixation of this type of injury reveals a 53% complication rate, where two-thirds (n = 35) of the patients required a second surgery for symptomatic hardware, 9,13,15,17 infection, 9,15 soft tissue breakdown, 17 pseudoarthrosis, 15 nonunion, 13 and heterotopic ossification. 16,17 Removal of hardware comprised the most common indication for reoperation (n = 23; 23%) (see Table 5).…”

Section: Discussionmentioning

confidence: 99%

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Alvara

Biedron

Dunn

2020

Hand (New York, N,Y.)

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Background: Despite increased utilization of conservative measures for displaced olecranon fractures in elderly patients, in whom operative fixation may be complicated by coexisting comorbidities and declining bone quality, the noninferiority of nonoperative management has yet to be proven. The purpose of this study was to review nonoperative management of displaced olecranon fractures in the elderly patient population. Methods: A literature search of the PubMed database was performed using the term olecranon fracture. Papers included those with results for patients aged 65 years and older published between 1990 and 2018 in the English language. Data were pooled to analyze outcomes and complications of nonoperative management of olecranon fractures in the elderly patient population. Results: Four eligible studies combined for a total of 69 patients with 70 fractures with an average age of 83.8 years (71-95 years), female predominance of 88%, and a mean follow-up of 12.4 months who underwent nonoperative management of displaced olecranon fractures. While only 25% of fractures went on to radiographic union, the mean Disabilities of the Arm, Shoulder, and Hand score was 16.9 (0-59.6), the mean arc of motion was 138°, and 92% of patients achieved excellent results. One-quarter (26%) of the patients experienced complications: radial head subluxation (1), skin sore (1), degenerative arthropathy (1), pain on movement (2), click in movement of the elbow (5), and local pain (8). Conclusion: Displaced olecranon fractures in patients aged older than 70 years may be effectively managed with nonoperative measures to produce high satisfaction and functional range of motion.

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Section: Discussionmentioning

confidence: 99%

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Alvara

Biedron

Dunn

2020

Hand (New York, N,Y.)

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“…It is reported that the incidence of elbow dislocations is 5.21 per 100,000 people every year in America [ 21 ]. Previous evidence has shown that patients with proximal ulna fractures can restore a stable and functional elbow by means of open reduction and internal fixation [ 22 ]. Open reduction and internal fixation have been proven to be effective in treating anteromedial facet fracture of ulna coronoid by anatomical reduction and strong fixation [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of internal fixation with mini plate and internal fixation with hollow screw for Regan-Morrey type II and III ulna coronoid fractures

Chen

Gao

2018

BMC Musculoskelet Disord

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BackgroundUlna coronoid fracture is a complicated injury and occurred in the coronal plane. Undeniably, there is no universally accepted approach for treating ulna coronoid fractures. Therefore, this study aimed at exploring the efficacy of different surgical treatments for Regan-Morrey type II and III ulna coronoid fractures.MethodsA total of 164 patients with ulna coronoid fractures were admitted and treated in department of orthopedics at Yiwu Central Hospital, the Affiliated Yiwu Hospital of Wenzhou Medical University for retrospective analysis. The baseline features (age, gender, time from injury to surgery and so on) before the surgery and different conditions during the surgery were compared. Following that, the Visual Analogue Scale (VAS) pain score was employed to evaluate the severity of preoperative and postoperative pain experienced by the patients in each group. Afterwards, Broberg and Morrey elbow score was used to evaluate elbow joint function and surgical effect of the patients. Lastly, the postoperative recovery and complications were compared.ResultsIt was firstly observed that internal fixation with mini plate and hollow screw compelled to lower average operation time and blood loss than Kirschner wire and steel wire suture. Next, the severity of postoperative pain was lessened in comparison with preoperative pain. Afterwards, mini plate and hollow screw improved elbow joint function more notable than Kirschner wire and steel wire suture, and Kirschner wire and steel wire suture resulted in higher incidence of complications and worse postoperative recovery.ConclusionCollectively, this study clarified that for the treatment of Regan-Morrey type II and III ulna coronoid fractures, internal fixation with mini plate and hollow screw has an overall superior surgical effect than internal fixation with Kirschner wire and steel wire suture.

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“…The displaced proximal ulna and the olecranon fractures are mostly stabilized by dorsal plates (Beser et al, 2014;George & Lawton, 2015;Melamed et al, 2015). The proximal and upper thirds of the ulnar fractures are surgically treated with open reduction and internal fixation In some cases if the fragments are not displaced, a simple splint immobilizing the forearm and preventing the elbow joint movements is adequate for rehabilitation (Brownhill et al, 2009).…”

Section: Introductionmentioning

confidence: 99%

“…Variability of the fractures determine the suitable implants such as plates (double or single), intramedullary nails, intramedullary screws and tension band wires (Brownhill et al;Hong et al, 2015;Niéto et al, 2015;Fuller, 2016). Each implant can maintain its stiffness and stability when properly selected (Windisch et al, 2007a,b;Melamed et al). Several factors such as intensive daily activities, inappropriate implant design and misalignment of the implants cause loosening of the implant components (Brownhill et al;Kim et al, 2011).…”

Section: Introductionmentioning

confidence: 99%

Surgical Importance of Radiographically Aided Morphometry of the Proximal Ulna

Erdem

2020

Int. J. Morphol.

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Huseyin ErdemERDEM, H. Surgical importance of radiographically aided morphometry of the proximal ulna. Int. J. Morphol., 38(2):299-304, 2020. SUMMARY:This study was conducted to define the proximal ulnar morphometry with respect to dorsal and intramedullary implant design. Eighty two dry Anatolian ulnae were evaluated by both the traditional and digital morphometric analysis methods. Also the medullary cavities and cortical bone thicknesses were measured from radiographic images. The mean value of ulnar length (UL) was 25.06 cm; distance between the most prominent anterior point of the superior surface of the olecranon (MAPO) and the most posterior point of the olecranon (MPPO), distance between the MPPO and maximum anterior angulation (MAA), distance between the MPPO and the maximum varus angulation (MVA) were; 1.67 cm, 5.36 cm and 7.56 cm, respectively. The average antero-posterior diameters at midolecranon plane (MOP), MAA plane (MAAP) and MVA plane (MVAP) were; 1.78 cm, 1.68 cm and 1.41 cm; transverse diameters of same planes were; 1.96 cm, 1.65 cm and 1.51 cm, respectively. The mean olecranon angle (OA), MAA and MVA were: 113.35°, 9.12°a nd 13.82°; also the mean circumferences at same planes were 6.48 cm, 6.37 cm and 5.16 cm, respectively. The mean antero-posterior medullary diameter at MAAP and mean transverse medullary diameter at MVAP were; 6.83 mm and 7.22 mm, respectively. Mean anterior and posterior cortical bone thicknesses at MAAP were: 3.61 mm and 4.25 mm; the mean medial and lateral cortical bone thicknesses at MVAP were: 4.06 mm and 4.13 mm, respectively. Dorsal angulation and medullary angulation of the proximal ulna presents different architecture. Unique morphological architecture of the proximal ulna should be taken into consideration in means of surgical operations and examination of radiographic images. It can be inferred that standardized bony landmarks may helpful during the process of designing and manufacturing precurved dorsal plates and as well as variable proximal ulnar implants. ERDEM, H. Surgical ımportance of radiographically aided morphometry of the proximal ulna. Int. J. Morphol., 38(2):299-304, 2020.

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Complex proximal ulna fractures: outcomes of surgical treatment

Abstract: III.

Cited by 13 publications

References 18 publications

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Nonoperative Management of Olecranon Fractures in Elderly Patients: A Systematic Review

Efficacy of internal fixation with mini plate and internal fixation with hollow screw for Regan-Morrey type II and III ulna coronoid fractures

Surgical Importance of Radiographically Aided Morphometry of the Proximal Ulna

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