Surgical treatment of ulnar olecranon avulsion fracture complicated with radial head fracture / 中华创伤骨科杂志

ABSTRACT

Objective:To evaluate the surgical treatment of ulnar olecranon avulsion fracture complicated with radial head fracture.Methods:A retrospective study was conducted to analyze the clinical data of 13 patients who had been treated at Department of Traumatology and Orthopedics, Beijing Jishuitan Hospital for ulnar olecranon avulsion fracture complicated with radial head fracture from July 2016 to February 2022. There were 9 males and 4 females with an age of (38.1±11.7 years), and 6 cases on the dominant side and 7 cases on the non-dominant side. According to Mason classification of radial head fractures, there were 1 case of type Ⅰ, 1 cases of type Ⅱ and 11 cases of type Ⅲ. All patients were treated surgically and their radial head fractures were prioritized. For radial head fractures, 10 patients were treated with open reduction and internal fixation, and 3 patients with radial head replacement. For ulnar olecranon avulsion fractures, 11 patients were treated with repair of tendon insertions, and 2 patients with tendon repair only. At the last follow-up, the elbow mobility was recorded, and Mayo elbow performance score (MEPS), visual analogue scale (VAS) for pain, and Disabilities of the Arm, Shoulder and Hand (DASH) scoring were applied to assess the elbow function, pain, and subjective upper extremity function. Complications and secondary surgeries were also followed up.Results:The 13 patients were followed up for (37.6±18.5) months after operation. At the last follow-up, the flexion and extension was 102.3°±19.6° (from 70° to 130°), and the pronation-supination was 149.6°±20.0° (from 110° to 170°). Nonunion of the radial head fracture occurred in 1 patient, stiffness of the elbow in 3 patients, and ulnar nerve dysfunction in 1 patient. A total of 4 secondary surgeries were performed in 3 patients. At the last follow-up, in the 13 patients, the MEPS score was 100.0 (85.0, 100.0) points with a range from 75 to 100 points; the VAS score was 0.0(0.0, 2.0) point with a range from 0 to 3 points; the DASH score was 2.5 (1.3, 8.3) points with a range from 0 to 21 points.Conclusions:As ulnar olecranon avulsion fracture complicated with radial head fracture is not common, timely identification and clear diagnosis of such injury is very important. Surgical treatment may result in fine outcomes.