Fracture-dislocations of the proximal ulna.

Abstract:

OBJECTIVE:To investigate the relationship between injury patterns, complications, and the functional outcomes of patients with proximal-ulna fracture-dislocations. METHODS:Retrospective analysis of 15 patients (10 men, 5 women; mean age, 49.1 years; mean follow-up 49 months) with 6 anterior and 9 posterior fracture-dislocations of the proximal ulna. The proximal ulna was reconstructed with plates and screws in 13 patients and tension-band wiring in 2 patients. At the final follow-up, elbow range of motion (ROM) was measured and Mayo elbow scores (MEPS) were recorded. Broberg-Morrey criteria were used for osteoarthritis staging. RESULTS:Concomitant radial-head fracture was seen in all posterior fracture-dislocations. Four ligamentous injuries occurred in this group. All anterior dislocations had trochlear-notch fractures without associated injuries. Mean flexion ROM was 130.6° (100°-140°) and mean loss of extension ROM was 12.6° (0°-30°) in the study group. The mean MEPS score was 92.3 (70-100). Patients with posterior fracture-dislocations showed lower ROM and MEPS and higher level of osteoarthritis than patients with anterior fracture-dislocations. Recurrent dislocations occurred in 2 patients who had ulna fractures fixed with tension-band wiring. CONCLUSION:Radial-head fracture and ligamentous injury are specific components of posterior fracture-dislocations. The injury is limited to the trochlear notch in anterior fracture-dislocations. Posterior fracture-dislocations have lower functional outcomes. Proximal-ulna fractures should be fixed with rigid internal fixation (plate and screw) even if the fracture is a simple 2-part fracture.

authors

Gereli A,Nalbantoğlu U,Dikmen G,Seyhan M,Türkmen M

doi

10.3944/AOTT.2015.14.0178

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

233-40

issue

3

eissn

1017-995X

issn

2589-1294

journal_volume

49

pub_type

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