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Complex proximal ulna fractures: outcomes of surgical treatment

  • Original Article • ELBOW - TRAUMA
  • Published:
European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

To review the results of plating of various fracture patterns of proximal ulna fractures including isolated olecranon fractures, olecranon fractures combined with a coronoid fracture, and olecranon fractures combined with a coronoid and radial head fracture.

Materials and methods

The study included 38 patients with either an isolated olecranon fracture or combined injuries, all treated with open reduction and internal fixation of the olecranon. Other procedures were performed as needed, including radial head fixation or arthroplasty, fixation of the coronoid, and repair of the lateral collateral ligament complex. There were 27 men and 11 women with an average age of 49 years. Clinical and radiographic assessment was obtained at an average follow-up time of 15 and 8.4 months, respectively.

Results

All fractures healed within 5 months. The average arc of ulnohumeral motion was 91° (range 0°–140°); average pronation–supination arc was 128° (range 0°–180°). Subgroup analysis showed a statistically significant lower rotational motion arc in patients with associated radial head (73°) or coronoid fractures (68°) compared to isolated olecranon fractures. All other parameters including ulnohumeral motion, complication rate, and revision rate were similar among the groups.

Conclusions

A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation. Loss of full flexion is likely with high-energy trauma, complex fracture patterns, and concomitant injuries. Fracture patterns involving the coronoid and/or the radial head are associated with restricted forearm rotation.

Level of evidence

III

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Conflict of interest

Eitan Melamed MD, Natalie Danna MD, Monika Debkowska, Raj Karia MPH, and Frank Liporace MD declare that they have no conflict of interest. John T Capo MD declares that he has received research support and consultant for Synthes Corporation, and Wright Medical Technology. He is also consultant and member of Speakers Panel Integra Life Sciences.

Ethical standards

This study has been approved by the local ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

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Authors and Affiliations

  1. Division of Hand Surgery, NYU Hospital for Joint Diseases, 550 First Avenue, New York, NY, 10016, USA

    Eitan Melamed, Natalie Danna, Monika Debkowska, Raj Karia, Frank Liporace & John T. Capo

Authors
  1. Eitan Melamed
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  2. Natalie Danna
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  3. Monika Debkowska
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  4. Raj Karia
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  5. Frank Liporace
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  6. John T. Capo
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Correspondence to Eitan Melamed.

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Melamed, E., Danna, N., Debkowska, M. et al. Complex proximal ulna fractures: outcomes of surgical treatment. Eur J Orthop Surg Traumatol 25, 851–858 (2015). https://doi.org/10.1007/s00590-015-1628-z

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  • DOI: https://doi.org/10.1007/s00590-015-1628-z

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