Fractures of the proximal ulna: current concepts in surgical management

EFORT Open Reviews
Sebastian SiebenlistKarl F Braun

Abstract

Fractures of the proximal ulna range from simple olecranon fractures to complex Monteggia fractures or Monteggia-like lesions involving damage to stabilizing key structures of the elbow (i.e. coronoid process, radial head, collateral ligament complex).In complex fracture patterns a computerized tomography scan is essential to properly assess the injury severity.Exact preoperative planning for the surgical approach is vital to adequately address all fracture parts (base coronoid fragments first).The management of olecranon fractures primarily comprises tension-band wiring in simple fractures as a valid treatment option, but modern plate techniques, especially in comminuted or osteoporotic fracture types, can reduce implant failure and potential implant-related soft tissue irritation.For Monteggia injuries, the accurate anatomical restoration of ulnar alignment and dimensions is crucial to adjust the radiocapitellar joint.Caution is advised if the anteromedial facet (anatomical insertion of the medial collateral ligament) of the coronoid process is affected, to avoid posteromedial instability.Radial head reconstruction or replacement is essential in Monteggia-like lesions to restore normal elbow function.The postoperative rehabil...Continue Reading

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Citations

Jul 11, 2020·International Orthopaedics·Juan Martín PatiñoBruno Marinucci
Sep 22, 2020·Zeitschrift für Orthopädie und Unfallchirurgie·Maria MützeChristoph Josten
Sep 19, 2020·BMC Musculoskeletal Disorders·Johannes Christof HopfPol Maria Rommens
Jun 10, 2021·Medicine·Agung R B SantosoMuhammad Abduh
Jul 3, 2021·Journal of Clinical Orthopaedics and Trauma·Qazi Manaan MasoodBijayendra Singh
Jul 16, 2021·Journal of Clinical Orthopaedics and Trauma·Lotte VerstuyftRoger van Riet

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