Transolecranon anterior fracture dislocation

Mouhsine, Elyazid; Akiki, Alain; Castagna, Alessandro; Cikes, Alec; Wettstein, Michaël; Borens, Olivier; Garofalo, Raffaele

doi:10.1016/j.jse.2006.07.005

Cited by 72 publications

(52 citation statements)

References 14 publications

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“…Internal fixation of all fractures is essential. However, ligamentous reconstruction is not usually necessary [23]. On the other hand, posterior fracture-dislocations of the olecranon, which are described as a type of posterior Monteggia injury, are often complex fractures that involve the proximal ulna, radial head, coronoid, and lateral collateral ligament 24,25].…”

Section: Discussionmentioning

confidence: 99%

Primary Hinged External Fixation of Terrible Triad Injuries and Olecranon Fracture-Dislocations of the Elbow

et al. 2016

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Summary:This study aimed to introduce a new treatment that apples primary hinged external fixation for complex fracture-dislocations of the elbow in 12 cases. We retrospectively assessed the functional outcomes of eight patients with terrible triad injuries and three patients with an olecranon fracture-dislocation of the elbow, who were treated at our hospital using a primary hinged external fixator between June 2012 and December 2014. Ten patients underwent repair or replacement of the radial head, while three underwent repair of the olecranon. In principle, they were treated without reconstruction of the coronoid fracture and collateral ligament injury. The patients were evaluated for a mean follow-up period of 16 months after the initial surgery. Early mobilization was encouraged while the hinged external fixator was in place. At the follow-up, the mean Mayo Elbow Performance Score was 93 points; the results were "excellent" in six cases and "good" in five. No patients had recurrent elbow instability. Only one patient needed an additional procedure after the initial operation. These results suggested that primary hinged external fixation without repair of the ligament and soft tissue is an effective minimally invasive surgery for the management of terrible triad injuries and olecranon fracture-dislocations of the elbow.

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Section: Discussionmentioning

confidence: 99%

Primary Hinged External Fixation of Terrible Triad Injuries and Olecranon Fracture-Dislocations of the Elbow

et al. 2016

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“…Some authors reported good results after the surgical treatment of transolecranon fracture-dislocation, and this seems to be particularly true when the radial head and collateral ligaments are not injured [54,55]. In these cases, reduction and olecranon osteosynthesis restore elbow stability.…”

Section: Transolecranon Fracture-dislocationmentioning

confidence: 99%

Management of complex elbow instability

et al. 2010

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Complex elbow instability is a challenging injury even for expert elbow surgeons. The preoperative radiographs should be carefully evaluated to recognize all lesions that may occur in complex elbow instabilities. Recognizing all the possible lesions is critical to achieve an optimal outcome. The most common types of injuries are as follows: (1) radial head fractures associated with lateral and medial collateral ligaments lesions (with or without elbow dislocation); (2) Coronoid fractures and lateral collateral ligament lesion (with or without elbow dislocation); (3) Terrible Triad; (4) Transolecranon fracture-dislocation; (5) Monteggia-like-lesions; and (6) Humeral Shear fractures associated with lateral and medial collateral ligaments lesions (with or without elbow dislocation). A correct evaluation includes X-rays, CT scan with 2D and 3D reconstruction and stability test under fluoroscopy. The treatment is always surgical and is challenging, and outcomes are not predictable. The goals of treatment are (1) to perform a stable osteosynthesis of all fractures, (2) to obtain concentric and stable reduction of the elbow and (3) to allow early motion. The proximal ulna must be anatomically reduced and fixed; the radial head must be repaired or replaced, and the coronoid fractures must be repaired or reconstructed. With respect of soft tissue lesions, the LUCL must be reattached with suture anchors or trans-osseous suture. The next critical step is the intra-operative assessment of elbow stability. If the elbow remains unstable, MCL repair and/or application of hinged external fixator must be considered. The most recent clinical and experimental studies have significantly expanded our knowledge of elbow instability and its management. Definite treatment protocols may improve the clinical results of such complex injuries.

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“…Basal coronoid fractures are also common and typically involve more than 50 % of the coronoid height [6]. Radial head fractures can occur concomitantly as well [5,7,8]. The collateral ligaments are usually spared [1,5].…”

Section: Trans-olecranon Fracture-dislocationsmentioning

confidence: 99%

“…Different techniques are available to obtain stable surgical fixation of the greater sigmoid notch, including tension-band wiring or plate osteosynthesis. Available literature suggests a higher failure rate with tension-band wiring [7,8], but if chosen, this technique should be reserved for simple, noncomminuted transverse or short oblique fractures of the olecranon [1,5]. In most cases, stable fixation can be achieved with a posterior plate.…”

Section: Trans-olecranon Fracture-dislocationsmentioning

confidence: 99%

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Treatment of complex elbow fracture-dislocations

Chan

King

Faber

2016

Curr Rev Musculoskelet Med

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Successful management of complex elbow fracture-dislocations requires, in part, recognition of the overall injury pattern, which can aid in the identification of concomitant bony and soft tissue injuries. Trans-olecranon fracture-dislocations are best treated surgically with stable anatomic restoration of the trochlear notch. Terrible triad elbow injuries are believed to be caused by a valgus posterolateral force. Although select terrible triad injuries can be managed non-operatively, the majority of injuries are treated with stable surgical repair to allow early elbow motion. Unlike terrible triads, varus posteromedial forces are theorized to cause anteromedial coronoid fractures. These are usually associated with LCL disruptions, but do not have concomitant MCL or radial head injuries. A subset of anteromedial coronoid fractures can also be managed non-operatively. Internal fixation is recommended for injuries associated with large fracture fragments or elbow instability preventing early motion.

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Transolecranon anterior fracture dislocation

Cited by 72 publications

References 14 publications

Primary Hinged External Fixation of Terrible Triad Injuries and Olecranon Fracture-Dislocations of the Elbow

Primary Hinged External Fixation of Terrible Triad Injuries and Olecranon Fracture-Dislocations of the Elbow

Management of complex elbow instability

Treatment of complex elbow fracture-dislocations

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