Transolecranon Fracture-Dislocation of the Elbow

Abstract

Anterior elbow dislocations occur most often as a fracture-dislocation in which the distal humerus is driven through the olecranon, thereby causing a complex, comminuted fracture of the proximal ulna. This injury is frequently confused with anterior Monteggia lesions by virtue of the readily apparent radiocapitellar dislocation. Stable restoration of the appropriate contour and dimensions of the trochlear notch of the ulna will lead to a good result in most cases.

Anterior Olecranon Fracture-Dislocations of the Elbow in Children

“…Tension-band wiring of the olecranon is thought to be inadequate fixation of an anterior olecranon fracture-dislocation in an adult, and, on the basis of the need for revision surgery in the only patient treated with tension-band wiring in our series, the same may be true in children 10 . We speculate that the added instability of the associated soft-tissue injury makes tensionband wiring insufficient, and plate-and-screw fixation seems preferable.…”

“…In other words, this is primarily an ulnohumeral fracture-dislocation rather than a radioulnar fracture-dislocation. Fracture of the coronoid occurs in half of the adult patients with an anterior olecranon fracture-dislocation 10 , but it has not been observed in children with this injury pattern.…”

“…1-A and 1-B). The coronoid is fractured in approximately half of the patients, the radial head is rarely injured, and the collateral ligaments are generally spared 10 . Olecranon fractures are relatively uncommon in skeletally immature patients [11][12][13] , and we were able to identify the cases of only three skeletally immature patients with an apparent anterior olecranon fracture-dislocation reported in the literature [7][8][9] .…”

“…. A search of this database identified four skeletally immature patients who had treatment of a so-called anterior, or transolecranon, fracture-dislocation of the elbow [1][2][3][4][5][6]10 . The database contained fourteen skeletally immature patients with a fracture of the olecranon over this time period, so that anterior olecranon fracture-dislocations represented nearly one-third of all olecranon fractures in skeletally immature individuals in the database.…”

Does K-wire position in tension band wiring of olecranon fractures affect its complications and removal of metal rate?

“…1,26,27 Ring et al 28 and Teasdall et al 29 reported that patient compliance, fracture comminution and extension into the ulnar diaphysis or coronoid process, concomitant radial head fracture and elbow instability may lead to inferior results. On the other hand, Villanueva et al 10 noted that fracture comminution does not necessary have a harmful effect on both clinical and radiological outcome.…”