Severely Comminuted Transolecranon Fracture Fixation with the Help of Medial Humerus Anatomical Plate: A Case Report and Educational Corner
-
Seyed Peyman Mirghaderi
,
Sadula Sharifpour
,
Amirhossein Ghaseminejad Raeini
,
Alireza Moharrami
,
Maryam Salimi
,
Seyed Hadi Kalantar
Abstract
Background: Transolecranon fracture is an unstable intra-articular injury in the elbow caused by high-energy trauma. Here, we introduce a medial humerus plate for severely comminuted transolecranon fracture.
Case Report: This article presents the case of a 29-year-old man who had a severely comminuted transolecranon fracture due to a motorcycle accident. A dorsal longitudinal approach was used in order to reach the fracture site. An olecranon anatomical plate and a medial humerus plate were applied for fixation, a new treatment method. The range of motion (ROM) was complete at a two-month follow-up, and the Mayo Elbow Performance Score (MEPS) was obtained 100 with no signs of complications.
Conclusion: Despite the several methods available for fixing transolecranon fractures, using the medial humerus plate, especially in severe comminution, can yield acceptable results. It should be considered in future studies to prove its efficacy in this type of fracture.
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2. Ring D, Jupiter JB, Sanders RW, Mast J, Simpson NS. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma. 1997;11(8):545-50. doi: 10.1097/00005131-199711000- 00001. [PubMed: 9415859].
3. Cho CH, Kim DH, Na SS, Choi BC, Kim BS. Trans-olecranon fracture-dislocations of the elbow: A systematic review. Diagnostics (Basel). 2020;10(12):1058. doi: 10.3390/diagnostics10121058. [PubMed: 33291269]. [PubMed Central: PMC7762091].
4. Flinterman HJ, Doornberg JN, Guitton TG, Ring D, Goslings JC, Kloen P. Long-term outcome of displaced, transverse, noncomminuted olecranon fractures. Clin Orthop Relat Res. 2014;472(6):1955-61. doi: 10.1007/s11999-014-3481-5. [PubMed: 24522384]. [PubMed Central: PMC4016441].
5. Wong JC, Getz CL, Abboud JA. Adult monteggia and olecranon fracture dislocations of the elbow. Hand Clin. 2015;31(4):565- 80. doi: 10.1016/j.hcl.2015.06.006. [PubMed: 26498546].
6. Hedayat E, Apostolou N, Mohammadi MA, Nabian MH. Step by step approach to interpretation of pediatric elbow radiography. J Orthop Spine Trauma. 2020;5(1):7-11. doi: 10.18502/jost.v5i1.3352.
7. Chan K, King GJ, Faber KJ. Treatment of complex elbow fracture-dislocations. Curr Rev Musculoskelet Med. 016;9(2):185-9. doi: 10.1007/s12178-016-9337-8. [PubMed: 26984334]. [PubMed Central: PMC4896880].
8. Doornberg J, Ring D, Jupiter JB. Effective treatment of fracture- dislocations of the olecranon requires a stable trochlear notch. Clin Orthop Relat Res. 2004;(429):292-300. doi: 10.1097/01.blo.0000142627.28396.cb. [PubMed: 15577501].
9. Hajivandi S, Dachek A, Salimi A, Mamaghani HJ, Mirghaderi SP, Dehghani J, et al. Comparison of the separate and combined effects of physiotherapy treatment and corticosteroid injection on the range of motion and pain in nontraumatic rotator cuff tear: A randomized controlled trial. Adv Orthop. 2021;2021:6789453. doi: 10.1155/2021/6789453. [PubMed: 34733561]. [PubMed Central: PMC8560293].
10. Salimi M, Dehghani J, Gerami MH. Efficacy of elastic intramedullary nails in treating axially unstable femur fracture in children. Pak J Med Health Sci. 2021;15(1):572-6
11. Sharafi M, Presedo A, Rabie H, Nabian MH. Flexion-type supracondylar humerus fracture: A review on reduction techniques. J Orthop Spine Trauma. 2020;4(3):54-8. doi: 10.18502/jost.v4i3.3079.
12. Luchetti TJ, Abbott EE, Baratz ME. Elbow fracture-dislocations: determining treatment strategies. Hand Clin. 2020;36(4): 495-510. doi: 10.1016/j.hcl.2020.07.011. [PubMed: 33040962].
13. Arain AR, Haddad S, Anderson M, Murtaza H, Rosenbaum A. Isolated pediatric transolecranon fracture-dislocation of the elbow managed nonoperatively: A case report and review of literature. Clin Case Rep. 2019;7(7):1435-8. doi: 10.1002/ccr3.2268. [PubMed: 31360506]. [PubMed Central: PMC6637335].
14. Mouhsine E, Akiki A, Castagna A, Cikes A, Wettstein M, Borens O, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg. 2007;16(3):352-7. doi: 10.1016/j.jse.2006.07.005. [PubMed: 17188909].
15. Yamaura K, Inui A, Mifune Y, Nishimoto H, Kataoka T, Kurosawa T, et al. Anterior transolecranon fracture dislocation with an associated avulsion fracture of coronoid process of ulna in a child: A case report. JSES Int. 2021;5(1):9-12. doi: 10.1016/j.jseint.2020.10.00. [PubMed: 33554156]. [PubMed Central: PMC7846680].
16. Lindenhovius AL, Brouwer KM, Doornberg JN, Ring DC, Kloen
P. Long-term outcome of operatively treated fracture- dislocations of the olecranon. J Orthop Trauma. 2008;22(5): 325-31. doi: 10.1097/BOT.0b013e31817283f7. [PubMed: 18448986].
17. Yang Z, Feng C, Bian Z, Lu M, Zhou D. Trans-olecranon fracture- dislocation of the elbow in children. Int Orthop. 2021;45(8): 2025-31. doi: 10.1007/s00264-021-05010-8. [PubMed: 33846848].
18. Lemsanni M, Najeb Y, Chafik R, Madhar M, Elhaoury H. Transolecranon fracture-dislocations of the elbow: A case series of 15 patients. Int J Res Orthop. 2020;6(6):1285-90. doi: 10.18203/issn.2455-4510.IntJResOrthop20204598.
19. Haller JM, Hulet DA, Hannay W, Cardon J, Tashjian R, Beingessner D. Patient outcomes after transolecranon fracture-dislocation. J Am Acad Orthop Surg. 2021;29(3):109-15. doi: 10.5435/JAAOS-D-20-00254. [PubMed: 32433427].
20. Luengo-Alonso G, Garcia LL, Jimenez D, V, Ferrero RJ, Porras Moreno MA, Cecilia LD. Trans-olecranon fracture dislocations: How should we treat them? Injury. 2021;52(Suppl 4):S131-S136. doi: 10.1016/j.injury.2021.02.058. [PubMed: 33642078].
21. O'Driscoll SW. Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg. 2005;14(1 Suppl S):186S-94S. doi: 10.1016/j.jse.2004.09.033. [PubMed: 15726080].
22. Sanchez-Sotelo J, Torchia ME, O'Driscoll SW. Complex distal humeral fractures: Internal fixation with a principle-based parallel-plate technique. J Bone Joint Surg Am. 2007;89(5): 961-9. doi: 10.2106/JBJS.E.01311. [PubMed: 17473132].
23. Zalavras CG, Papasoulis E. Intra-articular fractures of the distal humerus-a review of the current practice. Int Orthop. 2018;42(11):2653-62. doi: 10.1007/s00264-017-3719-4. [PubMed: 29404666].
24. Lor KKH, Toon DH, Wee ATH. Buttress plate fixation of coronoid process fractures via a medial approach. Chin J Traumatol. 2019;22(5):255-60. doi: 10.1016/j.cjtee.2019.05.005. [PubMed: 31492574]. [PubMed Central: PMC6823711].
2. Ring D, Jupiter JB, Sanders RW, Mast J, Simpson NS. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma. 1997;11(8):545-50. doi: 10.1097/00005131-199711000- 00001. [PubMed: 9415859].
3. Cho CH, Kim DH, Na SS, Choi BC, Kim BS. Trans-olecranon fracture-dislocations of the elbow: A systematic review. Diagnostics (Basel). 2020;10(12):1058. doi: 10.3390/diagnostics10121058. [PubMed: 33291269]. [PubMed Central: PMC7762091].
4. Flinterman HJ, Doornberg JN, Guitton TG, Ring D, Goslings JC, Kloen P. Long-term outcome of displaced, transverse, noncomminuted olecranon fractures. Clin Orthop Relat Res. 2014;472(6):1955-61. doi: 10.1007/s11999-014-3481-5. [PubMed: 24522384]. [PubMed Central: PMC4016441].
5. Wong JC, Getz CL, Abboud JA. Adult monteggia and olecranon fracture dislocations of the elbow. Hand Clin. 2015;31(4):565- 80. doi: 10.1016/j.hcl.2015.06.006. [PubMed: 26498546].
6. Hedayat E, Apostolou N, Mohammadi MA, Nabian MH. Step by step approach to interpretation of pediatric elbow radiography. J Orthop Spine Trauma. 2020;5(1):7-11. doi: 10.18502/jost.v5i1.3352.
7. Chan K, King GJ, Faber KJ. Treatment of complex elbow fracture-dislocations. Curr Rev Musculoskelet Med. 016;9(2):185-9. doi: 10.1007/s12178-016-9337-8. [PubMed: 26984334]. [PubMed Central: PMC4896880].
8. Doornberg J, Ring D, Jupiter JB. Effective treatment of fracture- dislocations of the olecranon requires a stable trochlear notch. Clin Orthop Relat Res. 2004;(429):292-300. doi: 10.1097/01.blo.0000142627.28396.cb. [PubMed: 15577501].
9. Hajivandi S, Dachek A, Salimi A, Mamaghani HJ, Mirghaderi SP, Dehghani J, et al. Comparison of the separate and combined effects of physiotherapy treatment and corticosteroid injection on the range of motion and pain in nontraumatic rotator cuff tear: A randomized controlled trial. Adv Orthop. 2021;2021:6789453. doi: 10.1155/2021/6789453. [PubMed: 34733561]. [PubMed Central: PMC8560293].
10. Salimi M, Dehghani J, Gerami MH. Efficacy of elastic intramedullary nails in treating axially unstable femur fracture in children. Pak J Med Health Sci. 2021;15(1):572-6
11. Sharafi M, Presedo A, Rabie H, Nabian MH. Flexion-type supracondylar humerus fracture: A review on reduction techniques. J Orthop Spine Trauma. 2020;4(3):54-8. doi: 10.18502/jost.v4i3.3079.
12. Luchetti TJ, Abbott EE, Baratz ME. Elbow fracture-dislocations: determining treatment strategies. Hand Clin. 2020;36(4): 495-510. doi: 10.1016/j.hcl.2020.07.011. [PubMed: 33040962].
13. Arain AR, Haddad S, Anderson M, Murtaza H, Rosenbaum A. Isolated pediatric transolecranon fracture-dislocation of the elbow managed nonoperatively: A case report and review of literature. Clin Case Rep. 2019;7(7):1435-8. doi: 10.1002/ccr3.2268. [PubMed: 31360506]. [PubMed Central: PMC6637335].
14. Mouhsine E, Akiki A, Castagna A, Cikes A, Wettstein M, Borens O, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg. 2007;16(3):352-7. doi: 10.1016/j.jse.2006.07.005. [PubMed: 17188909].
15. Yamaura K, Inui A, Mifune Y, Nishimoto H, Kataoka T, Kurosawa T, et al. Anterior transolecranon fracture dislocation with an associated avulsion fracture of coronoid process of ulna in a child: A case report. JSES Int. 2021;5(1):9-12. doi: 10.1016/j.jseint.2020.10.00. [PubMed: 33554156]. [PubMed Central: PMC7846680].
16. Lindenhovius AL, Brouwer KM, Doornberg JN, Ring DC, Kloen
P. Long-term outcome of operatively treated fracture- dislocations of the olecranon. J Orthop Trauma. 2008;22(5): 325-31. doi: 10.1097/BOT.0b013e31817283f7. [PubMed: 18448986].
17. Yang Z, Feng C, Bian Z, Lu M, Zhou D. Trans-olecranon fracture- dislocation of the elbow in children. Int Orthop. 2021;45(8): 2025-31. doi: 10.1007/s00264-021-05010-8. [PubMed: 33846848].
18. Lemsanni M, Najeb Y, Chafik R, Madhar M, Elhaoury H. Transolecranon fracture-dislocations of the elbow: A case series of 15 patients. Int J Res Orthop. 2020;6(6):1285-90. doi: 10.18203/issn.2455-4510.IntJResOrthop20204598.
19. Haller JM, Hulet DA, Hannay W, Cardon J, Tashjian R, Beingessner D. Patient outcomes after transolecranon fracture-dislocation. J Am Acad Orthop Surg. 2021;29(3):109-15. doi: 10.5435/JAAOS-D-20-00254. [PubMed: 32433427].
20. Luengo-Alonso G, Garcia LL, Jimenez D, V, Ferrero RJ, Porras Moreno MA, Cecilia LD. Trans-olecranon fracture dislocations: How should we treat them? Injury. 2021;52(Suppl 4):S131-S136. doi: 10.1016/j.injury.2021.02.058. [PubMed: 33642078].
21. O'Driscoll SW. Optimizing stability in distal humeral fracture fixation. J Shoulder Elbow Surg. 2005;14(1 Suppl S):186S-94S. doi: 10.1016/j.jse.2004.09.033. [PubMed: 15726080].
22. Sanchez-Sotelo J, Torchia ME, O'Driscoll SW. Complex distal humeral fractures: Internal fixation with a principle-based parallel-plate technique. J Bone Joint Surg Am. 2007;89(5): 961-9. doi: 10.2106/JBJS.E.01311. [PubMed: 17473132].
23. Zalavras CG, Papasoulis E. Intra-articular fractures of the distal humerus-a review of the current practice. Int Orthop. 2018;42(11):2653-62. doi: 10.1007/s00264-017-3719-4. [PubMed: 29404666].
24. Lor KKH, Toon DH, Wee ATH. Buttress plate fixation of coronoid process fractures via a medial approach. Chin J Traumatol. 2019;22(5):255-60. doi: 10.1016/j.cjtee.2019.05.005. [PubMed: 31492574]. [PubMed Central: PMC6823711].
| Files | ||
| Issue | Vol 8, No 3 (2022) | |
| Section | Case Report | |
| DOI | https://doi.org/10.18502/jost.v8i3.9910 | |
| Keywords | ||
| Elbow Elbow Joint Fracture Dislocation Olecranon Process | ||
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How to Cite
1.
Mirghaderi SP, Sharifpour S, Ghaseminejad Raeini A, Moharrami A, Salimi M, Kalantar SH. Severely Comminuted Transolecranon Fracture Fixation with the Help of Medial Humerus Anatomical Plate: A Case Report and Educational Corner. J Orthop Spine Trauma. 2022;8(3):97-100.
