Select a Community
Are you sure you want to trigger topic in your Anconeus AI algorithm?
You are done for today with this topic.
Would you like to start learning session with this topic items scheduled for future?
Open reduction and internal fixation with k-wires
1%
42/6863
Open reduction and internal fixation with tension band wiring
2%
146/6863
Open reduction and internal fixation with plate fixation
96%
6579/6863
Open reduction and internal fixation with an intramedullary screw
46/6863
Cast immobilization
0%
11/6863
Select Answer to see Preferred Response
Based on the radiographs shown, the patient has a comminuted trans-olecranon fracture dislocation of the elbow. Stability will be optimized with internal fixation in the form of a plating construct. Trans-olecranon fracture dislocations often occur in the young secondary to high energy mechanisms. Direct blows often lead to high levels of comminution; the distal humerus is driven into the proximal ulna and olecranon, thereby leading to a concomitant dislocation. In this setting, the optimal treatment is use of a plate and screw fixation construct to provide mechanical stability. Veillette et al. review the epidemiology, pathophysiology and treatment options for olecranon fractures. They highlight that because olecranon injuries involve the articular surface, fixation constructs should allow anatomic restoration of the joint surface. Additionally, fixation constructs should allow for early mobilization in order to prevent stiffness of the elbow. Mortazavi et al. retrospectively reviewed eight patients who sustained anterior trans-olecranon fracture dislocations of the elbow. Based on their experience, they recommend use of plate fixation to optimize stability of the elbow. Additionally, they indicate that satisfactory results can be obtained if the greater sigmoid notch is appropriately reduced. Figures A and B show the AP and lateral radiographs of a trans-olecranon fracture dislocation of the elbow. Severe comminution of the olecranon can be seen on the lateral radiograph in Figure B. Incorrect Answers: Answers 1, 2, 4: K-wires alone would not provide optimal stability and allow for early motion. A tension-band construct or IM screw fixation is contraindicated with this degree of comminution. Answer 5: Use of cast immobilization would lead to high levels of stiffness and is not indicated for this patient.
4.2
(16)
Please Login to add comment