OPERATIVE TREATMENT OF ANTERIOR OLECRANON FRACTURE-DISLOCATION_Chinese Journal of Reparative and Reconstructive Surgery

Authors：

HU Xiaochuan , XIANG Ming , CHEN Hang , YANG Shun , TANG Haochen , YANG Guoyong.

Department of Upper Extremity Trauma, Sichuan Orthopaedic Hospital, Chengdu Sichuan, 610041, P.R.China. Corresponding author: XIANG Ming, E-mail: josceph_xm@sina.com;

Corresponding author：

Keywords：

Elbow joint; Anterior olecranon fracture-dislocation; Internal fixation

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Objective To investigate the method and effectiveness of operative treatment of anterior olecranon fracture-dislocation. Methods Between January 2007 and December 2010, 10 cases of anterior olecranon fracture-dislocation were treated. There were 6 males and 4 females with an average age of 46.1 years (range, 27-68 years). The injury was caused by traffic accident in 7 cases, falling from height in 2 cases, and falling in 1 case. Nine cases were fresh fracture and 1 case was old fracture. There were 9 cases of ulnar olecranon comminuted fracture and 1 case of simple oblique fracture. Associated fractures were Regan-Morrey type III coronoid process fractures in 5 cases, Mason type II radial head fracture in 1 case, and Mason type III radial head fracture in 1 case. Open reduction and internal fixation were performed in all cases: reconstruction plates were used in 4 cases, tension band and reconstruction plates in 5 cases, and tension band and one-third tubular plate in 1 case; bone graft was performed in 2 cases. Results All incisions healed by first intention. The patients were followed up 12-26 months (mean, 19.8 months). The X-ray films showed that fractures healing was achieved at 12-24 weeks (mean, 16.4 weeks). No failure of internal fixation, ulnohumeral joint instability, or traumatic arthritis occurred. At last follow-up, the elbow function score was 69-100 (mean, 89.1) according to the Broberg-Morrey evaluation criteria; the results were excellent in 4 cases, good in 4 cases, and fair in 2 cases with an excellent and good rate of 80%. The Disability of Arm-Shoulder-Hand (DASH) score was 0-22 (mean, 9). The visual analogue score (VAS) was 0-3 (mean, 0.5). Conclusion For anterior olecranon fracture-dislocation, an early and stable anatomic reconstruction of the trochlear notch of the ulna with plates and early active mobilization are given, the good functional results can be obtained.

Citation： HU Xiaochuan,XIANG Ming,CHEN Hang,YANG Shun,TANG Haochen,YANG Guoyong.. OPERATIVE TREATMENT OF ANTERIOR OLECRANON FRACTURE-DISLOCATION. Chinese Journal of Reparative and Reconstructive Surgery, 2012, 26(12): 1462-1465. doi: Copy

1.	Ring D, Jupiter JB, Sanders RW, et al. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma, 1997, 11(8): 545-550.
2.	Mouhsine E, Akiki A, Castagna A, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg, 2007, 16(3): 352-357.
3.	Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg (Am), 1986, 68(5): 669-674.
4.	Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med, 1996, 29(6): 602-608.
5.	陈振兵, 洪光祥, 王发斌. 上肢功能评定表. 中国修复重建外科杂志, 2004, 18(6): 520-521.
6.	Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg (Am), 1998, 80(4): 566-580.
7.	蒋协远, 王满宜, 黄强, 等. 尺骨鹰嘴骨折合并肘关节前脱位的手术治疗. 中华骨科杂志, 2000, 20(3): 154-156.
8.	Bucholz RW. 洛克伍德-格林成人骨折. 6版. 裴国献, 译. 北京: 人民军医出版社, 2009: 875.
9.	Lindenhovius AL, Brouwer KM, Doornberg JN, et al. Long-term outcome of operatively treated fracture-dislocations of the olecranon. J Orthop Trauma, 2008, 22(5): 325-331.
10.	Doornberg J, Ring D, Jupiter JB. Effective treatment of fracture-dislocations of the olecranon requires a stable trochlear notch. Clin Orthop Relat Res, 2004, (429): 292-300.
11.	Jupiter JB, Leibovic SJ, Ribbans W, et al. The posterior Monteggia lesion. J Orthop Trauma, 1991, 5(4): 395-402.
12.	Ring D, Jupiter JB, Simpson NS. Monteggia fractures in adults. J Bone Joint Surg (Am), 1998, 80(12): 1733-1744.
13.	Ruedi TP, Buckley R, Moran C. 骨折治疗的AO原则. 危杰, 刘璠, 吴新宝, 等译. 上海: 上海科学技术出版社, 2010: 476.
14.	李庭, 蒋协远, 张健, 等. 成人尺骨近端向后孟氏损伤的诊断与治疗. 中华外科杂志, 2009, 47(12): 899-902.
15.	滕林, 钟刚, 肖聪, 等. 重建钢板联合张力带治疗尺骨上段合并鹰嘴骨折. 中国修复重建外科杂志, 2011, 25(1): 17-20.
16.	Mortazavi SM, Asadollahi S, Tahririan MA. Functional outcome following treatment of transolecranon fracture-dislocation of the elbow. Injury, 2006, 37(3): 284-288.
17.	Siebenlist S, Torsiglieri T, Kraus T, et al. Comminuted fractures of the proximal ulna—Preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury, 2010, 41(12): 1306-1311.
18.	Buijze GA, Blankevoort L, Tuijthof GJ, et al. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg, 2010, 130(4): 459-464.
19.	Ochtman AE, Ring D. Combined posterior and medial plate fixation of complex proximal ulna fractures. Injury, 2012, 43(2): 254-256.
20.	McKay PL, Katarincic JA. Fractures of the proximal ulna olecranon and coronoid fractures. Hand Clin, 2002, 18(1): 43-53.

1. Ring D, Jupiter JB, Sanders RW, et al. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma, 1997, 11(8): 545-550.
2. Mouhsine E, Akiki A, Castagna A, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg, 2007, 16(3): 352-357.
3. Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg (Am), 1986, 68(5): 669-674.
4. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med, 1996, 29(6): 602-608.
5. 陈振兵, 洪光祥, 王发斌. 上肢功能评定表. 中国修复重建外科杂志, 2004, 18(6): 520-521.
6. Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg (Am), 1998, 80(4): 566-580.
7. 蒋协远, 王满宜, 黄强, 等. 尺骨鹰嘴骨折合并肘关节前脱位的手术治疗. 中华骨科杂志, 2000, 20(3): 154-156.
8. Bucholz RW. 洛克伍德-格林成人骨折. 6版. 裴国献, 译. 北京: 人民军医出版社, 2009: 875.
9. Lindenhovius AL, Brouwer KM, Doornberg JN, et al. Long-term outcome of operatively treated fracture-dislocations of the olecranon. J Orthop Trauma, 2008, 22(5): 325-331.
10. Doornberg J, Ring D, Jupiter JB. Effective treatment of fracture-dislocations of the olecranon requires a stable trochlear notch. Clin Orthop Relat Res, 2004, (429): 292-300.
11. Jupiter JB, Leibovic SJ, Ribbans W, et al. The posterior Monteggia lesion. J Orthop Trauma, 1991, 5(4): 395-402.
12. Ring D, Jupiter JB, Simpson NS. Monteggia fractures in adults. J Bone Joint Surg (Am), 1998, 80(12): 1733-1744.
13. Ruedi TP, Buckley R, Moran C. 骨折治疗的AO原则. 危杰, 刘璠, 吴新宝, 等译. 上海: 上海科学技术出版社, 2010: 476.
14. 李庭, 蒋协远, 张健, 等. 成人尺骨近端向后孟氏损伤的诊断与治疗. 中华外科杂志, 2009, 47(12): 899-902.
15. 滕林, 钟刚, 肖聪, 等. 重建钢板联合张力带治疗尺骨上段合并鹰嘴骨折. 中国修复重建外科杂志, 2011, 25(1): 17-20.
16. Mortazavi SM, Asadollahi S, Tahririan MA. Functional outcome following treatment of transolecranon fracture-dislocation of the elbow. Injury, 2006, 37(3): 284-288.
17. Siebenlist S, Torsiglieri T, Kraus T, et al. Comminuted fractures of the proximal ulna—Preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury, 2010, 41(12): 1306-1311.
18. Buijze GA, Blankevoort L, Tuijthof GJ, et al. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg, 2010, 130(4): 459-464.
19. Ochtman AE, Ring D. Combined posterior and medial plate fixation of complex proximal ulna fractures. Injury, 2012, 43(2): 254-256.
20. McKay PL, Katarincic JA. Fractures of the proximal ulna olecranon and coronoid fractures. Hand Clin, 2002, 18(1): 43-53.

Chinese Journal of Reparative and Reconstructive Surgery

OPERATIVE TREATMENT OF ANTERIOR OLECRANON FRACTURE-DISLOCATION

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