Elsevier

The Journal of Hand Surgery

Volume 34, Issue 2, February 2009, Pages 357-362
The Journal of Hand Surgery

Current concept
Proximal Ulna Fractures

https://doi.org/10.1016/j.jhsa.2008.12.022Get rights and content

Proximal ulna fractures are relatively common. They range in severity from a simple transverse olecranon fracture to a highly complex fracture dislocation involving a comminuted coronoid process. The anatomy, fracture pathology, treatment approach, and rehabilitation are presented in this article.

Section snippets

Olecranon Fractures

Olecranon fractures are relatively common adult injuries that are a result of direct or indirect forces. Direct forces drive the olecranon into the distal humerus and result in comminuted fractures of the olecranon. Indirect forces, applied through contraction of the triceps, often result in transverse or short oblique types of fractures.

Several different methods of internal fixation have been described for fracture treatment. The fracture pattern plays a role in determining the fixation that

Coronoid Fractures

Coronoid fractures occur in association with other fractures and soft tissue injuries, usually elbow dislocations. Different patterns of coronoid fractures are now known to be associated with different modes of elbow instability. There are several classification systems for coronoid fractures. With the Regan and Morrey classification,7 the elbow is evaluated using a lateral radiograph, and coronoid fractures are divided into 3 categories: type 1, tip fractures commonly associated with posterior

References (9)

  • N.S. Simpson et al.

    Contoured LCDC plating of the proximal ulna

    Injury

    (1996)
  • D.J. Hak et al.

    Olecranon fractures: treatment options

    J Am Acad Orthop Surg

    (2000)
  • M.C. Hume et al.

    Olecranon fractures: a clinical and radiographic comparison of tension band wiring and plate fixation

    Clin Orthop Relat Res

    (1992)
  • I.S. Fyfe et al.

    Methods of fixation of olecranon fracturesAn experimental mechanical study

    J Bone Joint Surg

    (1985)
There are more references available in the full text version of this article.

Cited by (43)

  • Fractures of the proximal forearm

    2016, Shoulder and Elbow Trauma and its Complications
  • Olecranon fractures

    2016, Shoulder and Elbow Trauma and its Complications
  • Reconstruction of Monteggia-like proximal ulna fractures using different fixation devices: A biomechanical study

    2016, Injury
    Citation Excerpt :

    Tension banding still seems to be the most popular treatment option for simple olecranon fractures [24], although a surprisingly high complication rate [11,17,24] and hopeful results for other treatment options [14] were described. For more complex fractures of the olecranon and especially for Monteggia-like lesions with a complete comminution of the proximal ulna including a separation of the coronoid process, simple tension banding is not sufficient. [23] Recommendations for these complex fracture entities range from dorsal plating over locked angle dorsal plating to double plating or nailing of the proximal ulna [4,6,7,8,9,13,19,20,23].

View all citing articles on Scopus

No benefits in any form have been received or will be received related directly or indirectly to the subject of this article.

View full text