Fractures of the proximal ulna

• Olecranon fractures;

• fractures of the proc. coronoideus ulnae.

Olecranon fractures

An olecranon fracture is an intra-articular

• A fracture of the olecranon ulnae is intra-articular.

• It is caused by a fall on the flexed elbow or by severe flexion with typical dislocation of the fragment by pulling the m. triceps brachii proximally, and may be associated with anterior luxation of the elbow joint.

Colton classification

• non-displaced stable fractures;

• dislocated fractures:

• avulsion;

• transverse and oblique fractures;

• isolated splinter fractures;

• luxation fractures (ventral luxation at the elbow joint).

Clinical picture and diagnosis

• Clinically, there is pain, swelling, haematoma with a palpable fragment or even a fracture line.

• X-ray is performed in two projections.

Treatment

• always surgical;
  • open repossession and osteosynthesis (tension cerclage, tension screw, splint for fragility fractures);
  • for luxation fractures, primary suture of ligaments and capsule;
• only very rarely conservative;
  • if surgery is contraindicated;
  • immobilisation with a plaster splint in semiflexion.

Fractures of the proc. coronoideus ulnae

• Isolated is rare, usually part of posterior luxations of the elbow.

Classification

• marginal avulsion;

• avulsion up to ½ the height of the proc. coronoideus;

• avulsion of more than ½ proc. coronoideus.

Treatment

• A dislocated fragment may impede the final stage of flexion - in this case, osteosynthesis with a screw is indicated; smaller fragments may be extirpated; non-dislocated fragments are sutured in plaster fixation for 3 weeks.

Links

Related articles

• Fractures of the forearm
  • Combined fractures of the radius and ulna
  • Isolated fractures of the radius and ulna
  • Smith's fracture
  • Monteggia fracture
  • Galeazzi fracture
  • Colles fracture
• Radius
• Ulna

Source

• PASTOR, Jan. Langenbeck's medical web page [online]. [cit. 2022-17-12]. <http://langenbeck.webs.com>.