Trans-olecranon fracture posterior dislocation: a novel type of elbow injury
Abstract Background Based on our experiences, we found that a kind of elbow injury is characterized by an olecranon fracture accompanied by elbow joint posterior dislocation with the proximal radioulnar joint intact. The aim of this study was to better define this kind of severe elbow instability, w...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-03-01
|
| Series: | Journal of Orthopaedic Surgery and Research |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s13018-023-03563-5 |
| _version_ | 1827983236615110656 |
|---|---|
| author | Fulin Tao Dongsheng Zhou Wenhao Song |
| author_facet | Fulin Tao Dongsheng Zhou Wenhao Song |
| author_sort | Fulin Tao |
| collection | DOAJ |
| description | Abstract Background Based on our experiences, we found that a kind of elbow injury is characterized by an olecranon fracture accompanied by elbow joint posterior dislocation with the proximal radioulnar joint intact. The aim of this study was to better define this kind of severe elbow instability, which has not been previously reported. Methods We retrospectively analyzed all patients with olecranon fractures who were treated at our institution from January 2013 to April 2021. Data on these patient demographics, injury characteristics, preoperative and postoperative imaging, surgical management, and outcomes were recorded and analyzed. We also made the inclusion criteria and exclusion criteria. Results A total of 309 patients were diagnosed olecranon fractures in our institution, and ten patients met the inclusion criteria, 9 males and 1 female, with an average age of 40.6 ± 12.7 years (26–68 years). Eight patients (80%) were comminuted, and two were oblique olecranon fracture. Nine patients (90%) suffered coronoid process fractures, eight fractures were type III, and one was type II. Eight patients (80%) suffered radial head fractures, seven fractures were type II, and one was type III. All patients suffered lateral collateral ligament complex injury. All patients underwent surgical management and were followed up on average for 15.8 ± 3.2 months (12–20 months). The motion of the elbow and functional outcome were evaluated with several methods. The mean arc of the elbow movement was 131.6° ± 6.0° (124°–140°), and the mean arc of the forearm rotation was 158.5° ± 17.8° (128°–180°). Nine patients’ functional results according to the Mayo Elbow Performance Score (MEPS) were excellent with a mean score of 96.5 ± 5.3 points (85–100 points), and another was good. The mean score according to the Broberg and Morrey functional rating index was 98.8 ± 2.5 points (92–100 points), nine patients were excellent, and another was good. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 0.75 ± 1.2 points (0–3.3 points). Conclusions Trans-olecranon fracture posterior dislocation is a rare injury and has unique characteristics, and it is a kind of complex elbow instability involving the coronoid process and radial head fractures. After bony structure is restored, the repairment of lateral collateral ligament complex is also important to the stability of the elbow joint. Correct understanding of this kind of injury and reasonable treatment plan can achieve good function. |
| first_indexed | 2024-04-09T22:45:36Z |
| format | Article |
| id | doaj.art-221aa1b667884ac6b7fcad87c66ce078 |
| institution | Directory Open Access Journal |
| issn | 1749-799X |
| language | English |
| last_indexed | 2024-04-09T22:45:36Z |
| publishDate | 2023-03-01 |
| publisher | BMC |
| record_format | Article |
| series | Journal of Orthopaedic Surgery and Research |
| spelling | doaj.art-221aa1b667884ac6b7fcad87c66ce0782023-03-22T11:51:11ZengBMCJournal of Orthopaedic Surgery and Research1749-799X2023-03-011811810.1186/s13018-023-03563-5Trans-olecranon fracture posterior dislocation: a novel type of elbow injuryFulin Tao0Dongsheng Zhou1Wenhao Song2Department of Orthopedic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityDepartment of Orthopedic Surgery, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong UniversityDepartment of Orthopedic Surgery, Shandong Provincial Hospital Affiliated to Shandong First Medical UniversityAbstract Background Based on our experiences, we found that a kind of elbow injury is characterized by an olecranon fracture accompanied by elbow joint posterior dislocation with the proximal radioulnar joint intact. The aim of this study was to better define this kind of severe elbow instability, which has not been previously reported. Methods We retrospectively analyzed all patients with olecranon fractures who were treated at our institution from January 2013 to April 2021. Data on these patient demographics, injury characteristics, preoperative and postoperative imaging, surgical management, and outcomes were recorded and analyzed. We also made the inclusion criteria and exclusion criteria. Results A total of 309 patients were diagnosed olecranon fractures in our institution, and ten patients met the inclusion criteria, 9 males and 1 female, with an average age of 40.6 ± 12.7 years (26–68 years). Eight patients (80%) were comminuted, and two were oblique olecranon fracture. Nine patients (90%) suffered coronoid process fractures, eight fractures were type III, and one was type II. Eight patients (80%) suffered radial head fractures, seven fractures were type II, and one was type III. All patients suffered lateral collateral ligament complex injury. All patients underwent surgical management and were followed up on average for 15.8 ± 3.2 months (12–20 months). The motion of the elbow and functional outcome were evaluated with several methods. The mean arc of the elbow movement was 131.6° ± 6.0° (124°–140°), and the mean arc of the forearm rotation was 158.5° ± 17.8° (128°–180°). Nine patients’ functional results according to the Mayo Elbow Performance Score (MEPS) were excellent with a mean score of 96.5 ± 5.3 points (85–100 points), and another was good. The mean score according to the Broberg and Morrey functional rating index was 98.8 ± 2.5 points (92–100 points), nine patients were excellent, and another was good. The mean Disabilities of the Arm, Shoulder, and Hand (DASH) score was 0.75 ± 1.2 points (0–3.3 points). Conclusions Trans-olecranon fracture posterior dislocation is a rare injury and has unique characteristics, and it is a kind of complex elbow instability involving the coronoid process and radial head fractures. After bony structure is restored, the repairment of lateral collateral ligament complex is also important to the stability of the elbow joint. Correct understanding of this kind of injury and reasonable treatment plan can achieve good function.https://doi.org/10.1186/s13018-023-03563-5Elbow joint dislocationOlecranon fractureSevere elbow instability |
| spellingShingle | Fulin Tao Dongsheng Zhou Wenhao Song Trans-olecranon fracture posterior dislocation: a novel type of elbow injury Journal of Orthopaedic Surgery and Research Elbow joint dislocation Olecranon fracture Severe elbow instability |
| title | Trans-olecranon fracture posterior dislocation: a novel type of elbow injury |
| title_full | Trans-olecranon fracture posterior dislocation: a novel type of elbow injury |
| title_fullStr | Trans-olecranon fracture posterior dislocation: a novel type of elbow injury |
| title_full_unstemmed | Trans-olecranon fracture posterior dislocation: a novel type of elbow injury |
| title_short | Trans-olecranon fracture posterior dislocation: a novel type of elbow injury |
| title_sort | trans olecranon fracture posterior dislocation a novel type of elbow injury |
| topic | Elbow joint dislocation Olecranon fracture Severe elbow instability |
| url | https://doi.org/10.1186/s13018-023-03563-5 |
| work_keys_str_mv | AT fulintao transolecranonfractureposteriordislocationanoveltypeofelbowinjury AT dongshengzhou transolecranonfractureposteriordislocationanoveltypeofelbowinjury AT wenhaosong transolecranonfractureposteriordislocationanoveltypeofelbowinjury |