Trans-olecranon fracture dislocations: How should we treat them?

• Published in: Injury Vol. 52; pp. S131 - S136
• Main Authors: Luengo-Alonso, G., García Lamas, L., Jiménez Díaz, V., Ferrero Recasens, J., Porras Moreno, MA, Cecilia López, D.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 01-07-2021
• Subjects: Elbow complex fracture dislocation; Elbow instability; Elbow surgery; Monteggia-like injuries; Trans-olecranon fracture dislocation; Monteggia-like injuries; Elbow complex fracture dislocation; Elbow instability; Trans-olecranon fracture dislocation; Elbow surgery
• ISSN: 0020-1383; 1879-0267
• DOI: 10.1016/j.injury.2021.02.058

•Transolecranon fracture-dislocations are not a common injury. Following a standardized protocol helps surgeons facing this type of injury.•Standardized protocol treating fractures allows surgeons to performed a procedure in a routinely way, making sure we follow critical steps to avoid complications.•There are only a few and small series dealing with transolecranon fracture-dislocations. Sharing experience and results could help surgeons to achieve better outcomes.
Trans-olecranon fracture dislocations are the least frequent complex elbow instability. Proper surgical treatment should be performed to avoid postoperative complications.
A retrospective design study was performed. Patients that suffered from this injury, treated at our center from 2010 to 2016 were included. Fifteen patients were analyzed. Functional results were measured using DASH, MEPS and VAS scores. Average time from injury to first surgical treatment was 4.87 days. Radial head fracture was present in seven cases and coronoid process in three patients. Most frequent complication was hardware disturbances in five patients. Mean follow up was 3.65 years.
Mean range of motion (ROM) was evaluated 1 year postoperatively: 129° flexion, 6° flexion contracture, and less than 5° deficit of pronation/supination. Clinical and functional results are encouraging, DASH 36.38, MEPS 100 and VAS 0.46.
Trans-olecranon fracture dislocations could obtain functional range of movement, pain relief and good functional outcomes with a standardized protocol of surgical fixation. It is important to achieve proper ulnar fixation, focusing in reestablishing dorsal angulation, and also to treat radial head and coronoid injuries properly, if present.