Current Concepts in the Treatment of Complex Elbow Fracture-Dislocation

Hyun-Dae Shin; Soo-Min Cha

doi:10.12671/jkfs.2012.25.4.342

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Shin and Cha: Current Concepts in the Treatment of Complex Elbow Fracture-Dislocation

Review Article

Journal of the Korean Fracture Society

Journal of the Korean Fracture Society 2012; 25(4): 342-351.

Published online: 19 October 2012

DOI: https://doi.org/10.12671/jkfs.2012.25.4.342

Current Concepts in the Treatment of Complex Elbow Fracture-Dislocation

Hyun-Dae Shin, M.D., Ph.D., Soo-Min Cha, M.D.

Department of Orthopaedic Surgery, Research Institute for Medical Sciences, Chungnam National University Hospital, Daejeon, Korea.

Address reprint requests to: Hyun-Dae Shin, M.D., Ph.D. Department of Orthopaedic Surgery, Research Institute for Medical Sciences, Chungnam National University Hospital, 282, Munhwa-ro, Jung-gu, Daejeon 301-721, Korea. Tel: 82-42-280-7349, Fax: 82-42-252-7098, hyunsd@cnu.ac.kr

Figures and Tables

Fig. 1

Algorithm for the surgical management of the terrible triad injury to the elbow. ^*Radial neck osteotomy in preparation for radial head replacement. ^†Type I coronoid fractures may not require repair. Revised from the article of Mathew PK, et al. (Fig. 5) with permission28).

Fig. 2

(A) Preoperative antero-posterior and lateral radiographs.

(B) Regan and Morrey type I coronoid fracture, type I radial head fracture was observed in computed tomography.

(C) Only lateral ulnar collateral ligament has been sutured with Mitek anchor and stability was achieved.

Fig. 3

Postoperative anteroposterior and lateral radiographs show reduced joint with fixation of the coronoid process.

Fig. 4

Illustration depicting the lasso coronoid fracture fixation technique through ulnar drill holes (Revised from Garrigues GE, et al. (Fig. 3) with permission17).

Fig. 5

(A) Subluxated radiocapitellar joint was observed despite manual reduction of terrible triad injury.

(B) Anteroposterior and lateral radiographs of an elbow fracture-dislocation that inadequately characterized the extent of bony injury. Three-dimensional computed tomography scan showing anteromedial facet fragment and olecrenon fragment.

(C) Locking plate and screws were used for fixation of coronoid fracture and olecrenon fragment.

Fig. 6

Anteroposterior and lateral radiographs of an elbow fracture-dislocation that inadequately characterized the extent of bony injury. Three-dimensional computed tomography scans show the radial head fracture and associated comminuted proximal ulnar and coronoid fracture.

Table 1

Rehabilitation Protocol after Surgical Treatment of Elbow Dislocations with Radial Head Fracture with or without Coronoid Fracture

LCL: Lateral collateral ligament, MCL: Medial collateral ligament.

Table 2

O'Driscoll Classification of Coronoid Process Fractures

References

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