Olecranon Fractures Pathway Posted: 2/20/2022 ID: (C102006)

Transolecranon Fx/Dislocation with Ipsilateral Distal Radius Fx in 38F

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PRESENTATION
5
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POLLS
8,436
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OUTCOMES
6
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VIDEOS
3
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EVIDENCE
20
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Comments
19
CASE DESCRIPTION
AGE 38 / Male
CC Right Arm Pain
HPI A 38-year-old female was involved in an MVC and injured her right arm. She states that her right arm struck the dashboard during the collision. She immediately felt pain and was unable to use her arm afterward. She has been transferred to your hospital for further evaluation. She denies any pain in any other extremity. She denies any head trauma or loss of consciousness.
PMH No significant past medical history. Urine pregnancy test is negative
PE A focused physical exam reveals swelling and deformity present over the right elbow and wrist. Skin is intact with no active bleeding. There is pain with the attempted range of motion of the elbow and the wrist. Tenderness to palpation is present over the elbow, forearm, and wrist. Motor and sensation are present in all peripheral nerve distributions. Pulses are present and palpable.
Pre-procedure IMAGES:
https://upload.orthobullets.com/cases/102006/c950e11d-a209-458e-809e-d905f1106efc_screen_shot_2022-02-20_at_9.02.30_am.jpg https://upload.orthobullets.com/cases/102006/8a8bea9c-6290-4863-8e0b-4768899abf9b_screen_shot_2022-02-20_at_9.03.18_am.jpg https://upload.orthobullets.com/cases/102006/3bc83546-a048-430f-9009-177ed12eb77a_screen_shot_2022-02-20_at_9.02.52_am.jpg https://upload.orthobullets.com/cases/102006/f7633f6e-dce4-4689-91fa-84937632110d_screen_shot_2022-02-20_at_9.02.00_am.jpg https://upload.orthobullets.com/cases/102006/1905c9ee-52d1-4666-a92f-b073bfb78f9e_screen_shot_2022-02-20_at_9.02.41_am.jpg
POLLS
OB Community
1) In addition to plain radiographs, would you obtain any further imaging to guide your treatment?
Other
2) Would you use a classification system to guide management?
Other
3) How would you definitively manage this patient?
Other
4) If you choose Operative management, which fractures would you fix and in what order?
Other
5) If you choose Operative management, considering the patient presented to the ER at 2 PM on a weekday on the day of injury, what would be your time frame to take him to surgery and where would you do it?
Other
6) If you choose Operative management for the olecranon fracture, what surgery would you perform?
Other
7) If you choose Open reduction internal fixation (ORIF) for the olecranon fracture, which technique would you utilize?
Other
8) If you choose Operative management for the distal radius fracture, what surgical technique would you use?
Other
9) If you choose Open reduction and internal fixation (ORIF) for the distal radius fracture, what approach would you use?
Other
10) If you choose Operative management and attained the construct shown, when would you allow weight-bearing post-operatively?
Other
11) If you choose Operative management and attained the construct shown below, when would you allow full active motion of the elbow?
Other
12) If you choose Operative management and attained the construct shown below, would you treat with heterotopic ossification (HO) prophylaxis?
Other
CASE OUTCOMES
PROCEDURE 1: olecranon open reduction and internal fixation distal radius open reduction and internal fixation
DOP: 2/16/2022
Intra-procedure P1
https://upload.orthobullets.com/cases/102006/96e17b6a-b3ec-4939-91b0-0642b776270e_screen_shot_2022-02-20_at_9.04.23_am.jpg https://upload.orthobullets.com/cases/102006/1dad56b2-e88d-4fc0-acb6-98166d2228ce_screen_shot_2022-02-20_at_9.04.51_am.jpg https://upload.orthobullets.com/cases/102006/796d1598-dac9-46a1-bbd9-15a277ee85e6_screen_shot_2022-02-20_at_9.05.22_am.jpg https://upload.orthobullets.com/cases/102006/afb93d49-b96c-4a73-9365-e372f6b360e7_screen_shot_2022-02-20_at_9.05.03_am.jpg https://upload.orthobullets.com/cases/102006/d4fa7dec-07c8-4f62-8975-2ac666a7fd03_screen_shot_2022-02-20_at_9.32.22_am.jpg https://upload.orthobullets.com/cases/102006/8ccf7408-8f66-42ec-b89d-cee5c1936cda_screen_shot_2022-02-20_at_9.34.20_am.jpg
VIDEOS & PODCASTS (3)
EVIDENCE (20)
EXPERT COMMENTS