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Takuya Matsumoto - One of the best experts on this subject based on the ideXlab platform.
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reverse oblique Olecranon Fracture
Orthopaedic Proceedings, 2018Co-Authors: T Iga, T Karita, W Sato, Hiroshi Okazaki, T Tatsumi, C Touhara, T Nishikawa, I Nagai, M Ushita, Takuya MatsumotoAbstract:IntroductionIn oblique Olecranon Fracture, Fracture line begins in the trochlear notch and proceeds distally to the dorsal cortex of the ulna. We have experienced a nonunion of reverse oblique Fracture.HypothesisReverse oblique Olecranon Fracture has instability.Materials & Methods130 patients with an Olecranon Fracture were retrospectively evaluated. Inclusion criteria are that Fracture line begins at the base of the coronoid process, distal portion of the trochlear notch, and proceeds proximally to the dorsal cortex of the ulna on the lateral radiograph. Fractures with articular comminution were excluded.ResultsSeven patients met the criteria. They were associated with local injuries: anterior translation of the proximal radius and ulna, Fracture of the medial epicondyle or the lateral condyle of the humerus. One out of five patients treated with tension band wiring (TBW) was revised with screw fixation because of nonunion.DiscussionThe associated injuries suggested the anterior and valgus instability. ...
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reverse oblique Olecranon Fracture
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: T Iga, T Karita, W Sato, Hiroshi Okazaki, T Tatsumi, C Touhara, T Nishikawa, I Nagai, M Ushita, Takuya MatsumotoAbstract:Introduction In oblique Olecranon Fracture, Fracture line begins in the trochlear notch and proceeds distally to the dorsal cortex of the ulna. We have experienced a nonunion of reverse oblique Fracture. Hypothesis Reverse oblique Olecranon Fracture has instability. Materials & Methods 130 patients with an Olecranon Fracture were retrospectively evaluated. Inclusion criteria are that Fracture line begins at the base of the coronoid process, distal portion of the trochlear notch, and proceeds proximally to the dorsal cortex of the ulna on the lateral radiograph. Fractures with articular comminution were excluded. Results Seven patients met the criteria. They were associated with local injuries: anterior translation of the proximal radius and ulna, Fracture of the medial epicondyle or the lateral condyle of the humerus. One out of five patients treated with tension band wiring (TBW) was revised with screw fixation because of nonunion. Discussion The associated injuries suggested the anterior and valgus instability. A nonunion case suggests a requirement of more secure fixation. However, these findings are common in distal Olecranon Fracture. Therefore, the instability in our series is due to the distal location of Fracture on the trochlear notch rather than reverse obliquity. The reverse obliquity attributes to small proximal fragment. Conclusion Reverse oblique Olecranon Fracture has instability because of its distal location. It should be distinguished from simple, stable Fracture.
David Ring - One of the best experts on this subject based on the ideXlab platform.
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Persistent Medial Subluxation of the Ulna with Radiotrochlear Articulation
Mashhad University of Medical Sciences, 2017Co-Authors: Amir R. Kachooei, David RingAbstract:Two patients-one with a terrible triad Fracture dislocation and one with an anterior Olecranon Fracture dislocation—weretreated for maltracking of the elbow (medial subluxation). The radial head articulated with the lateral trochlea while theulnar trochlear notch was perched over the medial trochlea. The late revision surgery could not correct the subluxationbecause the joints were accustomed to the new alignment, however the overall function was reasonable
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Fracture line distribution of Olecranon Fractures
Archives of Orthopaedic and Trauma Surgery, 2017Co-Authors: Bart Lubberts, Jos J. Mellema, Stein J. Janssen, David RingAbstract:Purpose The association between specific Olecranon Fracture characteristics (e.g., displacement, fragmentation, subluxation) and Fracture line distribution might help surgeons predict intra-articular Fracture location based on Fracture characteristics that can be determined on radiographs. We hypothesized that Fracture mapping techniques would reveal different Fracture patterns for minimally displaced Fractures, displaced Fractures, and Fracture–dislocations of the Olecranon. Methods A consecutive series of 78 patients with Olecranon Fractures were evaluated using initial radiographs and computed tomography scans and characterized according to the Mayo classification. Fracture lines were identified based on reduced three-dimensional computed tomography reconstructions and graphically superimposed onto a standard template to create two-dimensional Fracture maps. The Fracture maps were then converted into Fracture heat maps. Based on Fracture and heat maps, Fracture line location and patterns were determined. Results Six (7.7%) patients had a non- or minimally displaced Fracture, 22 (28%) a displaced Fracture, and 50 (64%) a Fracture–dislocation of the Olecranon. There were 27 (54%) anterior and 23 (46%) posterior Olecranon Fracture–dislocations. Fracture lines of non- or minimally displaced Fractures and posterior Fracture–dislocations enter and exit the trochlear notch at the base of the coronoid, while Fracture lines of displaced Fractures and anterior Fracture–dislocations were spread more broadly over the depths of the trochlear notch. Conclusions Based on Fracture characteristics depicted on radiographs, one can anticipate the amount of the Olecranon involved (how close is the Fracture line to the coronoid) and the orientation of the Fracture line. Computer tomography could be reserved for when more specific knowledge of the Fracture line might affect treatment. Level of evidence: III.
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Fracture line distribution of Olecranon Fractures
Archives of Orthopaedic and Trauma Surgery, 2016Co-Authors: Bart Lubberts, Jos J. Mellema, Stein J. Janssen, David RingAbstract:Purpose The association between specific Olecranon Fracture characteristics (e.g., displacement, fragmentation, subluxation) and Fracture line distribution might help surgeons predict intra-articular Fracture location based on Fracture characteristics that can be determined on radiographs. We hypothesized that Fracture mapping techniques would reveal different Fracture patterns for minimally displaced Fractures, displaced Fractures, and Fracture–dislocations of the Olecranon.
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anterior Olecranon Fracture dislocations of the elbow in children a report of four cases
Journal of Bone and Joint Surgery American Volume, 2009Co-Authors: Thierry G Guitton, Robert G H Albers, David RingAbstract:A subset of Olecranon Fractures with loss of normal articular apposition (subluxation or dislocation) is recognized in adults as anterior and posterior Olecranon Fracture-dislocations1-6, but such injuries in skeletally immature patients have been rarely described7-9. The anterior Olecranon Fracture-dislocation may resemble an anterior Monteggia lesion in that there is anterior dislocation of the radial head with respect to the capitellum; however, the forearm (the radioulnar relationship) remains intact and the injury is primarily to the ulnohumeral joint by means of disruption of the trochlear notch (Figs. 1-A and 1-B). The coronoid is Fractured in approximately half of the patients, the radial head is rarely injured, and the collateral ligaments are generally spared10. Olecranon Fractures are relatively uncommon in skeletally immature patients11-13, and we were able to identify the cases of only three skeletally immature patients with an apparent anterior Olecranon Fracture-dislocation reported in the literature7-9. Figs. 1-A and 1-B Drawings differentiating between anterior Olecranon Fracture-dislocation and anterior Monteggia injuries. Fig. 1-A In the anterior Olecranon Fracture-dislocation, the proximal radioulnar joint remains aligned and intact, but there is an anterior dislocation of the radiocapitellar joint along with the rest of the forearm. Fig. 1-B In the anterior Monteggia Fracture, there is a Fracture of the ulna with anterior dislocation of the radial head. We identified four skeletally immature patients with an anterior Olecranon Fracture-dislocation from a Fracture registry. This report describes the injury characteristics, treatment methods, and results of these four patients. ### Materials and Methods Between 1974 and 2002, all Fractures treated at our institution were entered into a database …
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long term outcome of operatively treated Fracture dislocations of the Olecranon
Journal of Orthopaedic Trauma, 2008Co-Authors: Anneluuk L C Lindenhovius, David Ring, Kim M Brouwer, Job N Doornberg, Peter KloenAbstract:Objectives: To report the long-term results of operative treatment of anterior and posterior Olecranon Fracture-dislocations and compare them with the results recorded fewer than 2 years after surgery. Design: Retrospective case series with long-term evaluation. Setting: Level I trauma center. Patients and Participants: Ten patients with anterior Olecranon Fracture-dislocation and ten patients with posterior Olecranon Fracture-dislocation were evaluated after an average of 18 years (range, 11 to 28 years) after injury. Fifteen patients had an early follow-up available at an average 14 months (range, 6 to 24 months) after surgery. The average age at injury was 30 years (range, 14 to 53 years). Intervention: Treatment included plate and screw fixation (11 patients), tension band wiring (8 patients), and radiocapitellar transfixation (1 patient). Six patients had additional elbow surgery before the final evaluation. Main Outcome Measurements: Flexion arc, arthrosis, Mayo Elbow Performance Index (MEPI), Disability of Arm Shoulder and Hand questionnaire (DASH). Results: The mean arc of elbow flexion was 105 degrees (range, 15 to 140 degrees) at 1 year and 122 degrees (range 10 to 145 degrees; P = 0.01) at final evaluation. Radiographic arthrosis was observed in 14 patients (70%): severe in 3, moderate in 2, and mild in 9 patients. Five patients (25%) had ulnar nerve dysfunction at the final evaluation. The MEPI was excellent in 13 patients, good in 4, fair in 2, and poor in 1. The mean DASH score was 9 points (range, 0 to 53 points). Conclusion: The initial results of operative treatment of Fracture-dislocations of the Olecranon are durable over time.
T Gurpinar - One of the best experts on this subject based on the ideXlab platform.
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clinical and radiological evaluation of surgical management in Olecranon Fracture dislocations
Musculoskeletal Surgery, 2020Co-Authors: Y Ozturkmen, E şukur, Yunus Emre Akman, A şenel, T GurpinarAbstract:Purpose The treatment of Olecranon Fracture–dislocations (OFDs) remains challenging. OFDs are often misdiagnosed as Monteggia lesions, and the real frequency is actually higher. However, studies on OFDs are limited. This study aimed to report on the surgical management of OFDs and to highlight the importance of three-dimensional computed tomography (3D CT) evaluation in the treatment of OFDs.
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Clinical and radiological evaluation of surgical management in Olecranon Fracture–dislocations
MUSCULOSKELETAL SURGERY, 2019Co-Authors: Y Ozturkmen, E şukur, Yunus Emre Akman, A şenel, T GurpinarAbstract:Purpose The treatment of Olecranon Fracture–dislocations (OFDs) remains challenging. OFDs are often misdiagnosed as Monteggia lesions, and the real frequency is actually higher. However, studies on OFDs are limited. This study aimed to report on the surgical management of OFDs and to highlight the importance of three-dimensional computed tomography (3D CT) evaluation in the treatment of OFDs. Materials and methods The study participants included 18 patients (11 men, 7 women, mean age 44 years (range 24–78) with OFDs. Each patient’s medical records, radiographs, and 3D CT scans were reviewed for demographics, injury details, operative findings, and information about radiological and functional outcomes. The patients were divided into 2 groups according to the direction of the dislocation: the posterior dislocation group (group 1, 7 patients) and anterior dislocation group (group 2, 11 patients). The clinical evaluation was performed according to Broberg–Morrey and the American Shoulder and Elbow Surgeons-Elbow (ASES-E) scoring systems. Results The mean follow-up period was 39 months (range 25–62 months). The Broberg–Morrey results were excellent in 4, good in 9, fair in 3, and poor in 2 patients. The mean ASES-E score was 84.83 (range 48–100) points. There were signs of ulna-humeral arthrosis in 5 elbows. Arthrosis was graded as grade 1, grade 2, and grade 3 in 3, 1, and 1 elbows, respectively. Partial sensory recovery was observed in one patient with postoperative ulnar neuropathy at the last follow-up visit. Conclusions OFDs are complex injuries of the proximal ulna and may involve the radial head, coronoid process, and lateral collateral ligament. The effective treatment of OFDs begins with the proper identification of the injury with 3D CT. A secure fixation including the coronoid process is mandatory for the elbow joint stability. Insufficient restoration of the trochlear notch may lead to problems with loss of motion and arthrosis. Although an application of a pre-contoured locking anatomical Olecranon plate can simplify the fixation procedure in most cases, the surgeons’ equipment should also include radial head implant, coronoid plates, headless screws, small cannulated screw system, suture anchors, fluoroscopy, and articulated external fixator.
Chulhyun Cho - One of the best experts on this subject based on the ideXlab platform.
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trans Olecranon Fracture dislocations of the elbow a systematic review
Diagnostics (Basel Switzerland), 2020Co-Authors: Chulhyun Cho, Duhan Kim, Byungchan Choi, Beomsoo KimAbstract:The purpose of this study is to provide a systematic review of the definition, ideal surgical method, complications, and prognosis of trans-Olecranon Fracture dislocations. An electronic search was performed in the PubMed, EMBASE, Scopus, and MEDLINE databases. The eligibility criteria included retrospective clinical study and review article in subjects older than 18 years with trans-Olecranon Fracture dislocations. Trans-Olecranon Fracture dislocations are defined as Fractures in which the stability of the ulnohumeral joint is lost due to the intra-articular Fracture of the Olecranon without disruption of the proximal radioulnar joint. The seven papers were included that met the eligibility criteria for the quantitative synthesis. Findings indicate that a pre-contoured plate was used in 88.3% of cases (68 of 77 reports), with no reports of complications, suggesting that the pre-contoured 3.5 mm plate is the first choice of treatment. Postoperative mean elbow range of motion for the flexion–extension arc was 121.1° and 146.5° for the pronation-supination arc. Methods for postoperative clinical scores included the Broberg/Morrey rating with a result of excellent or good in 82.9% of cases, the ASES score with a mean of 88.7, and the DASH score with a mean of 11.75. Complications included heterotopic ossification in 21.9% (23/105) of cases, arthrosis in 25.7% (27/105) of cases, nerve damage in 18.1% (19/105) of cases, and osteoarthritis in 14.3% (15/105). With better understanding of the mechanism of injury and proper diagnosis and treatment, findings of the current review suggest a positive outcome. PROSPERO registration No.: CRD42019126568.
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total ankylosis by heterotopic ossification in an adolescent anterior trans Olecranon Fracture dislocation a case report
Computational Intelligence, 2019Co-Authors: Beomsoo Kim, Kwang Soon Song, Kicheor Bae, Siwook Lee, Chulhyun ChoAbstract:The incidence of heterotopic ossification in adolescents appears to be lower than in adults. There exist very few reports of heterotopic ossification with total bony ankylosis in child or adolescent populations. We describe a case of total bony ankylosis of the elbow secondary to heterotopic ossification, in a 14-year-old female. Total ankylosis of the elbow at 45 degrees of flexion was noted 6 months post-surgery, and complete surgical excision of the heterotopic mass was performed. After an additional one-time dose of radiation therapy and nonsteroidal anti-inflammatory drug medication, full range of motion was obtained without any recurrence or other complications, up to the last follow-up of 30 months.
T Iga - One of the best experts on this subject based on the ideXlab platform.
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reverse oblique Olecranon Fracture
Orthopaedic Proceedings, 2018Co-Authors: T Iga, T Karita, W Sato, Hiroshi Okazaki, T Tatsumi, C Touhara, T Nishikawa, I Nagai, M Ushita, Takuya MatsumotoAbstract:IntroductionIn oblique Olecranon Fracture, Fracture line begins in the trochlear notch and proceeds distally to the dorsal cortex of the ulna. We have experienced a nonunion of reverse oblique Fracture.HypothesisReverse oblique Olecranon Fracture has instability.Materials & Methods130 patients with an Olecranon Fracture were retrospectively evaluated. Inclusion criteria are that Fracture line begins at the base of the coronoid process, distal portion of the trochlear notch, and proceeds proximally to the dorsal cortex of the ulna on the lateral radiograph. Fractures with articular comminution were excluded.ResultsSeven patients met the criteria. They were associated with local injuries: anterior translation of the proximal radius and ulna, Fracture of the medial epicondyle or the lateral condyle of the humerus. One out of five patients treated with tension band wiring (TBW) was revised with screw fixation because of nonunion.DiscussionThe associated injuries suggested the anterior and valgus instability. ...
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reverse oblique Olecranon Fracture
Journal of Bone and Joint Surgery-british Volume, 2013Co-Authors: T Iga, T Karita, W Sato, Hiroshi Okazaki, T Tatsumi, C Touhara, T Nishikawa, I Nagai, M Ushita, Takuya MatsumotoAbstract:Introduction In oblique Olecranon Fracture, Fracture line begins in the trochlear notch and proceeds distally to the dorsal cortex of the ulna. We have experienced a nonunion of reverse oblique Fracture. Hypothesis Reverse oblique Olecranon Fracture has instability. Materials & Methods 130 patients with an Olecranon Fracture were retrospectively evaluated. Inclusion criteria are that Fracture line begins at the base of the coronoid process, distal portion of the trochlear notch, and proceeds proximally to the dorsal cortex of the ulna on the lateral radiograph. Fractures with articular comminution were excluded. Results Seven patients met the criteria. They were associated with local injuries: anterior translation of the proximal radius and ulna, Fracture of the medial epicondyle or the lateral condyle of the humerus. One out of five patients treated with tension band wiring (TBW) was revised with screw fixation because of nonunion. Discussion The associated injuries suggested the anterior and valgus instability. A nonunion case suggests a requirement of more secure fixation. However, these findings are common in distal Olecranon Fracture. Therefore, the instability in our series is due to the distal location of Fracture on the trochlear notch rather than reverse obliquity. The reverse obliquity attributes to small proximal fragment. Conclusion Reverse oblique Olecranon Fracture has instability because of its distal location. It should be distinguished from simple, stable Fracture.
