Fracture of the Olecranon Process of the Ulna

McKeever, Francis M.; Buck, Ronald M.

doi:10.1001/jama.1947.02890010003001

Cited by 65 publications

(7 citation statements)

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“…McKeever (1947) wrote that up to 80% of the olecranon can be excised without causing instability of the elbow in comminuted fractures of the olecranon. An et al (1986), however, showed experimentally that excision of as little as 25% of the olecranon had significant effects on trochleaulna stability.…”

Section: Discussionmentioning

confidence: 99%

Radiographic measurements of normal elbows: Clinical relevance to olecranon fractures

et al. 2006

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This study aims to calculate a clinically relevant and intra-operatively accessible measure of olecranon length that could be reliably applied by the operating surgeon to optimise fixation of comminuted olecranon fractures. One hundred normal adult antero-posterior and lateral radiographs of the elbow were studied with respect to the proximal olecranon height (OH), trochlear notch width (TW) on lateral views, and trans-epicondylar distance (TED) and trochlear width distance (TWD) on AP views. Three mean ratios were then derived: TWD/TW, TED/TW and OH/TW. The average OH was 26.2 mm (range 21-29), TW was 24.7 mm (range 21-32), TED was 58.7 mm (range 49-74), and the TWD was 27.0 mm (range 22-32). The average ratio of TWD: TW was 1.08 (SD = 0.08), that of TED: TW was 2.38 (SD = 0.18) and OH/TW was 1.06 (SD = 0.08). Comminuted fractures of the olecranon are a surgical challenge since it is often impossible to gauge the correct length to achieve in reconstruction of the olecranon process. Our data can be easily applied to the clinical situation, by taking intra-operative radiographs, and calculating the ratios as demonstrated above. These will guide the surgeon to obtain a more reliable length of the olecranon intra-operatively.

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Section: Discussionmentioning

confidence: 99%

Radiographic measurements of normal elbows: Clinical relevance to olecranon fractures

et al. 2006

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“…1,2 Treatment options in comminuted osteoporotic fractures, therefore, may be limited to plate fixation or fragment excision with triceps advancement. [3][4][5] Fragment excision with triceps advancement may be indicated in elderly, low-demand patients with fracture fragments that involve less than 50% of the articular surface and are too comminuted for effective internal fixation. Plate fixation, although more anatomic, may be tenuous in multifragmented osteoporotoic bone leading to an increased risk of fixation failure 6 ( Fig.…”

Section: Introductionmentioning

confidence: 99%

An Off-Loading Triceps Suture for Augmentation of Plate Fixation in Comminuted Osteoporotic Fractures of the Olecranon

Izzi

Athwal

2012

Journal of Orthopaedic Trauma

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Comminuted osteoporotic olecranon fractures in the elderly are relatively common. Open reduction and internal plate fixation is a frequently used treatment option. In highly comminuted osteoporotic bone, fixation may be tenuous leading to an increased risk of fixation failure with loss of reduction and displacement of fracture fragments. The off-loading triceps suture technique is a load-sharing mechanism to decreases distraction forces caused by the extensor mechanism on comminuted osteopenic olecranon fracture fragments managed with plate fixation.

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“…Elbow stability, according to McKeever and Buck 32 , might be replaced by triceps reinsertion and scar tissue formation. Moreover, DEF allowed an early recovery of ROM, making this condition acceptable for the patient.…”

Section: Discussionmentioning

confidence: 99%

A Peculiar Case of Open Complex Elbow Injury with Critical Bone Loss, Triceps Reinsertion, and Scar Tissue might Provide for Elbow Stability?

Facco¹,

Politano²,

Marchesini³

et al. 2021

Strategies in Trauma and Limb Reconstruction

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A bstract Background Complex elbow injuries (CEIs) are severe and rare lesions, difficult to treat correctly due to the different patterns of clinical presentations. Standard methods cannot often be applied. The main goals of the treatment are performing a stable osteosynthesis of all fractures, obtaining a concentric and stable reduction of the elbow by repairing the soft tissue constraint lesions, and allowing early motion. Since the introduction of virtual reality (VR) approaches in clinical practice, three-dimensional (3D) computed tomography (CT) and 3D printing have revolutionised orthopaedic surgeries, thus helping to understand the anatomy and the pathology of complex cases. Case description We discussed a case of CEI, characterised by an extended soft tissue (IIIB Gustilo classification) and neurovascular lesions associated with bone loss in a young female patient. Olecranon fracture was type IIIB according to Mayo classification. We outlined the steps of a pluri-tissue reconstructive approach and stressed the importance of 3D printing in the preoperative planning for such cases. Finally, peculiar final functional patient outcomes were reported. Conclusion In this case, we found out that triceps reinsertion and scar process may provide for the joint stability in a low-demanding patient. 3D printing and VR approaches in clinical practice can be useful in the management of CEIs associated with an important bone and soft tissue loss. How to cite this article Facco G, Politano R, Marchesini A, et al. A Peculiar Case of Open Complex Elbow Injury with Critical Bone Loss, Triceps Reinsertion, and Scar Tissue might Provide for Elbow Stability? Strategies Trauma Limb Reconstr 2021;16(1):53–59.

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Fracture of the Olecranon Process of the Ulna

Cited by 65 publications

References 0 publications

Radiographic measurements of normal elbows: Clinical relevance to olecranon fractures

Radiographic measurements of normal elbows: Clinical relevance to olecranon fractures

An Off-Loading Triceps Suture for Augmentation of Plate Fixation in Comminuted Osteoporotic Fractures of the Olecranon

A Peculiar Case of Open Complex Elbow Injury with Critical Bone Loss, Triceps Reinsertion, and Scar Tissue might Provide for Elbow Stability?

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