The management of elbow trauma from a historical perspective

Klerk, Huub H. de; Doornberg, Job N.; Eygendaal, Denise; Jupiter, Jesse B.

doi:10.1016/j.jseint.2023.01.005

Cited by 2 publications

(2 citation statements)

References 27 publications

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“…4 It provides a bony buttress to posteriorly directed translation forces to the ulna, while it carries the attachment site for the anterior capsule (at an average of 5.9mm from coronoid tip), the brachialis tendon (volar base of coronoid) and the anterior bundle of the MCL (sublime tubercle). 5,6 The coronoid consists of two different facets: (1) the anterolateral one, which articulates with the lateral trochlea and switches laterally to the lesser sigmoid notch and (2) the anteromedial one, which articulates with the medial trochlea. The anteromedial facet is wider and taller, protruding medially as a relatively unsupported by the ulna metaphysis structure.…”

Section: Anatomy and Biomechanicsmentioning

confidence: 99%

“…The MCL remains usually intact, except for the case of a true elbow disolcation. 6 If neglected or not treated properly, the ulnohumeral joint is subject to varus stresses leading to rapidly progressing post-traumatic arthritis. 29 Unlike those in terrible triads, anteromedial facets fractures may have a significant variability in size and pattern.…”

Section: Typementioning

confidence: 99%

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Coronoid fractures and complex elbow instability: current concepts

Masouros,

Christakakis,

Georgiadou

et al. 2024

Orthopedic Reviews

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Fractures of the coronoid process typically occur as part of more complex injury patterns, such as terrible triads, trans-olecranon fracture-dislocations, posteromedial rotatory injuries or Monteggia-like lesions. Each pattern is associated with a specific type of coronoid fracture with regard to shape and size and specific soft-tissue lesions. O’ Driscoll classification incorporates those associations identifying three major types of fractures: tip, anteromedial facet, and basal fractures. The objective of this study is to review the most common types of complex elbow instability, identify the indications for coronoid fixation and guide the appropriate management. Tip fractures as those seen in terrible triads can conditionally left untreated provided that elbow stability has been restored after radial head fixation and ligaments repair. Anteromedial facet fractures benefit from a buttress plate, while large basilar fractures can be effectively secured with posteroanterior screws. Coronoid reconstruction with a graft should be considered in post-traumatic cases of chronic coronoid deficiency.

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Section: Anatomy and Biomechanicsmentioning

confidence: 99%

Section: Typementioning

confidence: 99%

Coronoid fractures and complex elbow instability: current concepts

Masouros,

Christakakis,

Georgiadou

et al. 2024

Orthopedic Reviews

View full text Add to dashboard Cite

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Primary Elbow Arthroplasty in the Management of Complex Distal Humerus Fractures

Mahajan,

Memon,

Mehta

et al. 2024

Cureus

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IntroductionComplex distal humerus fractures pose significant challenges in orthopedic surgery, especially when traditional open reduction and internal fixation (ORIF) is not feasible. Primary elbow arthroplasty has emerged as an alternative treatment option for these fractures, but its application remains limited. This study aimed to evaluate the functional outcomes, patient selection criteria, and follow-up results of primary elbow arthroplasty in the management of complex distal humerus fractures. MethodsA retrospective review was conducted on 15 patients who underwent primary elbow arthroplasty for Orthopaedic Trauma Association (OTA) type C distal humerus fractures between 2017 and 2023 at our institution. Inclusion criteria were patients aged 18 years or older who were offered either total elbow or hemiarthroplasty for acute complex distal humerus fracture. Data were collected from patient medical records, including demographic information, fracture classification, surgical details, and postoperative follow-up. Functional outcomes were assessed using the Oxford Elbow Score (OES) and Mayo Elbow Performance Score (MEPS). Complications were documented, and descriptive statistics were used to summarise the findings. ResultsThe mean age of the patients was 71.8 years (IQR 17 years), with 12 females and three males. The mean time to surgery was 14.7 days post-injury (IQR: 12 days). The mean follow-up duration was 52 weeks (range: 8-234 weeks, IQR: 27 weeks) and variability was noted. The mean flexion-extension arc at the final follow-up was 93° (IQR: 32.5°). The mean OES was 46 (IQR: 22), and the mean MEPS was 75 (IQR: 37), indicating good to excellent functional outcomes. Scores for two patients were not available due to dementia. Reported complications included one case of ulnar sensory symptoms and one case requiring metalwork removal following olecranon osteotomy. ConclusionPrimary elbow arthroplasty provides a viable treatment option for complex distal humerus fractures, demonstrating significant functional improvements and high patient satisfaction. However, the variability in follow-up and subjective decision-making underscores the need for standardized protocols. Future multicenter, prospective studies with larger cohorts and standardized follow-up protocols are recommended to confirm these findings and optimize patient care.

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The management of elbow trauma from a historical perspective

Cited by 2 publications

References 27 publications

Coronoid fractures and complex elbow instability: current concepts

Coronoid fractures and complex elbow instability: current concepts

Primary Elbow Arthroplasty in the Management of Complex Distal Humerus Fractures

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