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Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 2/2016

01-06-2016 | Elbow Soft Tissue Surgery (L Oh, Section Editor)

Treatment of complex elbow fracture-dislocations

Authors: Kevin Chan, Graham J. W. King, Kenneth J. Faber

Published in: Current Reviews in Musculoskeletal Medicine | Issue 2/2016

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Abstract

Successful management of complex elbow fracture-dislocations requires, in part, recognition of the overall injury pattern, which can aid in the identification of concomitant bony and soft tissue injuries. Trans-olecranon fracture-dislocations are best treated surgically with stable anatomic restoration of the trochlear notch. Terrible triad elbow injuries are believed to be caused by a valgus posterolateral force. Although select terrible triad injuries can be managed non-operatively, the majority of injuries are treated with stable surgical repair to allow early elbow motion. Unlike terrible triads, varus posteromedial forces are theorized to cause anteromedial coronoid fractures. These are usually associated with LCL disruptions, but do not have concomitant MCL or radial head injuries. A subset of anteromedial coronoid fractures can also be managed non-operatively. Internal fixation is recommended for injuries associated with large fracture fragments or elbow instability preventing early motion.
Literature
1.
Wyrick JD, Dailey SK, Gunzenhaeuser JM, Casstevens EC. Management of complex elbow dislocations: a mechanistic approach. J Am Acad Orthop Surg. 2015;23(5):297–306.CrossRefPubMed
2.
Stoneback JW, Owens BD, Sykes J, Athwal GS, Pointer L, Wolf JM. Incidence of elbow dislocations in the United States population. J Bone Joint Surg Am. 2012;94(3):240–5.CrossRefPubMed
3.
Lee GA, Katz SD, Lazarus MD. Elbow valgus stress radiography in an uninjured population. Am J Sports Med. 1998;26(3):425–7.PubMed
4.
Rhyou IH, Kim KC, Lee JH, Kim SY, et al. Strategic approach to O’Driscoll type 2 anteromedial coronoid facet fracture. J Shoulder Elb Surg. 2014;23(7):924–32.CrossRef
5.
Ring D, Jupiter JB, Sanders RW, Mast J, Simpson NS. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma. 1997;11(8):545–50.CrossRefPubMed
6.
O’Driscoll SW, Jupiter JB, Cohen MS, Ring D, McKee MD. Difficult elbow fractures: pearls and pitfalls. Instr Course Lect. 2003;52:113–34.PubMed
7.
Mortazavi SM, Asadollahi S, Tahririan MA. Functional outcome following treatment of transolecranon fracture-dislocation of the elbow. Injury. 2006;37(3):284–8.CrossRefPubMed
8.
Mouhsine E, Akiki A, Castagna A, Cikes A, Wettstein M, Borens O, et al. Transolecranon anterior fracture dislocation. J Shoulder Elb Surg. 2007;16(3):352–7.CrossRef
9.
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.CrossRefPubMed
10.
Mathew PK, Athwal GS, King GJ. Terrible triad injury of the elbow: current concepts. J Am Acad Orthop Surg. 2009;17(3):137–51.CrossRefPubMed
11.
Mellema JJ, Doornberg JN, Dyer GS, Ring D. Distribution of coronoid fracture lines by specific patterns of traumatic elbow instability. J Hand Surg. 2014;39(10):2041–6.CrossRef
12.
Doornberg JN, van Duijn J, Ring D. Coronoid fracture height in terrible-triad injuries. J Hand Surg. 2006;31(5):794–7.CrossRef
13.
Van Leeuwen DH, Guitton TG, Lambers K, Ring D, et al. Quantitative measurement of radial head fracture location. J Shoulder Elb Surg. 2012;21(8):1013–7.CrossRef
14.
Rineer CA, Guitton TG, Ring D, et al. Radial head fractures: loss of cortical contact is associated with concomitant fracture or dislocation. J Shoulder Elb Surg. 2010;19(1):21–5.CrossRef
15.
Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid. J Bone Joint Surg Am. 2002;84(4):547–51.PubMed
16.•
Chan K, MacDermid JC, Faber KJ, King GJ, Athwal GS. Can we treat select terrible triad injuries nonoperatively? Clin Orthop Relat Res. 2014;472(7):2092–9. This reference represents important and recent contributions to the treatment of complex elbow fracture-dislocations. It clarifies indications and outcomes for this difficult orthopedic injury. CrossRefPubMedPubMedCentral
17.
McKee MD, Pugh DM, Wild LM, Schemitsch EH, King GJ. Standard surgical protocol to treat elbow dislocations with radial head and coronoid fractures. Surgical technique. J Bone Joint Surg Am. 2005;87(1):22–32.PubMed
18.
Ring D, Quintero J, Jupiter JB. Open reduction and internal fixation of fractures of the radial head. J Bone Joint Surg Am. 2002;84(10):1811–5.PubMed
19.
Watters TS, Garrigues GE, Ring D, Ruch DS. Fixation versus replacement of radial head in terrible triad: is there a difference in elbow stability and prognosis? Clin Orthop Relat Res. 2014;472(7):2128–35.CrossRefPubMed
20.
Leigh WB, Ball CM, et al. Radial head reconstruction versus replacement in the treatment of terrible triad injuries of the elbow. J Shoulder Elb Surg. 2012;21(10):1336–41.CrossRef
21.
Jeon IH, Sanchez-Sotelo J, Zhao K, An KN, Morrey BM. The contribution of the coronoid and radial head to the stability of the elbow. J Bone Joint Surg. 2012;94(1):86–92.CrossRef
22.
Papatheodorou LK, Rubright JH, Heim KA, Weiser RW, Sotereanos DG. Terrible triad injuries of the elbow: does the coronoid always need to be fixed? Clin Orthop Relat Res. 2014;472(7):2084–91.CrossRefPubMedPubMedCentral
23.
Doornberg JN, De Jong IM, Lindenhovius AL, Ring D, et al. The anteromedial facet of the coronoid process of the ulna. J Shoulder Elb Surg. 2007;16(5):667–70.CrossRef
24.
Sanchez-Sotelo J, O’Driscoll SW, Morrey BF, et al. Medial oblique compression fracture of the coronoid process of the ulna. J Shoulder Elb Surg. 2005;14(1):60–4.CrossRef
25.
Doornberg JN, Ring DC. Fracture of the anteromedial facet of the coronoid process. J Bone Joint Surg Am. 2006;88(10):2216–24.CrossRefPubMed
26.
Pollock JW, Brownhill J, Ferreira L, McDonald CP, Johnson J, King G. The effect of anteromedial facet fractures of the coronoid and lateral collateral ligament injury on elbow stability and kinematics. J Bone Joint Surg Am. 2009;91(6):1448–58.CrossRefPubMed
27.
Moon JG, Bither N, Jeon YJ, Oh SM. Non surgically managed anteromedial coronoid fractures in posteromedial rotatory instability: three cases with 2 years follow-up. Arch Orthop Trauma Surg. 2013;133(12):1665–8.CrossRefPubMed
28.•
Park SM, Lee JS, Jung JY, Kim JY, Song KS, et al. How should anteromedial coronoid facet fracture be managed? A surgical strategy based on O’Driscoll classification and ligament injury. J Shoulder Elb Surg. 2015;24(1):74–82. This reference represents important and recent contributions to the treatment of complex elbow fracture-dislocations. It clarifies indications and outcomes for this difficult orthopedic injury. CrossRef
Metadata
Title
Treatment of complex elbow fracture-dislocations
Authors
Kevin Chan
Graham J. W. King
Kenneth J. Faber
Publication date
01-06-2016
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 2/2016
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-016-9337-8

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