Combined anterior and posterior approach in treatment of transolecranon fracture-dislocation / 中华创伤骨科杂志

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.