Outcome of locking plate fixation in cases of comminuted proximal ulna fractures

Abstract

Introduction: The purpose of this study was to report the clinical and radiological outcome following treatment with locking plate fixation in patients of comminuted fractures of the proximal ulna including olecranon and Monteggia fractures. Materials and Methods: Between 2015 and 2017, thirty patients with comminuted fractures of the proximal ulna including 21 cases of fracture olecranon and 9 cases of Monteggia fractures were managed with locking plate fixation. The patients were followed for clinical and radiological examination for minimum 6 months post operatively. Validated patient-oriented assessment scores involving the Mayo Elbow Performance Score (MEPS) and postoperative range of motion and patient's satisfaction were evaluated. Results: The mean arc of elbow motion in 21 cases of olecranon fractures was 108° and mean MEPS was 89.3 with 57% excellent and 43% good results. While in 9 cases of Monteggia fractures mean arc of motion was 108° and mean MEPS were 93.8 with 89% excellent and 11% good results. All patients achieved fracture union by 24 weeks. Mean duration of fracture union for olecranon fractures was 16.1 weeks and for Monteggia fractures 14.3 weeks. Conclusion: Locking plate is an effective fixation method for fractures of the proximal ulna allowing reliable stability for early elbow motion. The functional results are comparable with formerly described plating systems. The good radiological outcomes highlight the usefulness of plate fixation in cases of proximal ulna fractures, provided optimal plate positioning achieved. Keywords: Proximal ulna, Comminution, Locking plate, Olecranon fracture, Monteggia, Internal fixation.