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Abstract
Purpose
The purpose of this study is to evaluate the surgical outcomes of olecranon fracture dislocation in accordance with the direction of the dislocation.
Materials and Methods
From December 2006 to February 2016, the surgical outcome in patients who had been followed-up for a minimum of 6 months accompanied with olecranon fracture and elbow instability were reviewed retrospectively. We classified olecranon fracture as either the anterior type or the posterior type. Moreover, we evaluated the clinical results by the Mayo elbow performance scores (MEPS) and checked for any associated injury, age, injury mechanism, and complication.
Results
Fourteen patients had anterior transolecranon fracture dislocation, with an average age of 46 years. The associated lesions were radial head fractures found in 2 patients (14.3%) and coronoid process fracture found in 5 patients (35.7%). Patients with anterior transolecranon fracture showed an average MEPS of 93.2 (70–100). Eight patients with posterior olecranon fracture dislocation had an average age of 66 years (22–87 years). The associated lesions were radial head fractures in 6 patients (75.0%) and coronoid process fracture in 8 patients (100%). Patients with posterior olecranon fracture dislocation showed an average MEPS of 94.4 (80–100). In comparison with the anterior type, posterior type occurred more frequently in elders and showed a greater association with injuries, such as radial head fracture and coronoid process fracture. However, there was no significant difference between the two groups with respect to the clinical outcome.
Figures and Tables
Figure 2
A 58-year-old man was hit by a mass. (A) Lateral x-ray of anterior transolecranon fracture dislocation associated with distal humerus lateral condyle fracture and coronoid process fracture. (B) Open fracture of anterior transolecranon fracture dislocation. (C) Antibiotics impregnated cement implantation, which was performed on the lesion of open fracture and bone defect. (D) Removal of cement and internal fixation for the coronoid process fracture were performed on the 5th week following surgery. (E) Due to delayed infection sign of Methicillin sensitive Staphylococcus aureus, partial implant removal surgery was performed. On the final follow-up (18 months after surgery), 90° of elbow range of motion, 12°of flexion, and a Mayo elbow performance score of 70 were detected.
Figure 3
An 87-year-old woman fell on the ground and injured her left elbow. (A) Lateral x-ray of posterior olecranon fracture dislocation associated with the coronoid process fracture and radial head fracture. (B) Postoperative lateral x-ray of the patient fixed with a plate and screws. (C) After one-year, the patient had good results.
Table 1
Patient Demographics
*Secondary operation. †Implant removal. RH, radial head fracture; Coronoid, coronoid process fracture; Ligament OP, ligament operation; Open, open fracture; ROM, range of motion; FC, flexion contracture; MEPS, Mayo elbow performance score; Anterior, anterior transolecranon fracture dislocation; Posterior, posterior olecranon fracture dislocation; M, male; F, female; FH, fall from a height; HM, hit by mass; TA, traffic accident; FG, fall on the ground; E, excellent; F, fair; G, good; MSSA, Methicillin sensitive Staphylococcus aureus.
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