Combined anterior and posterior approach in treatment of transolecranon fracture-dislocation

Abstract

Objective To observe the treatment of transolecranon fracture-dislocation using combined anterior and posterior approach. Methods From September 2010 to October 2014, 6 patients(4 males and 2 females)with transolecranon fracture-dislocation were treated via the combined anterior and posterior approach at our department. Their average age was 42. 5 years(from 25 to 63 years). One case had open injury(Gustilo-Anderson type I)and 5 closed injury. Six cases were associated with coronoid process fracture and 5 with radial head fracture. Bone union was assessed by elbow anterioposterior and lateral radiographs. The elbow function was assessed at the last follow-up according to the Broberg-Morrey functional rating indexes. Results All the 6 patients achieved primary incision healing with no early complications. They were followed up for an average period of 14 months(from 9 to 22 months). All fractures healed 6 months post-operation. At the last follow-up, the average elbow flexion range was 127°(from 90° to 145°)and the average rotation range was 112°(from 80° to 150°). The mean Broberg and Morrey functional score was 89 points(from 74 to 96 points). Two cases were excellent, 3 good, and one moderate. No implant failure, heterotopic ossification or elbow instability was observed at the last follow-up. Conclusion In treatment of transolecranon fracture-dislocation, combined anterior and posterior approach provides clear vision which benefits anatomical reduction and stable fixation. Also it allows early mobilization of the elbow and leads to good short-term results. Key words: Ulnar fractures; Dislocations; Fracture fixation, internal