J Korean Orthop Assoc.  2010 Dec;45(6):496-500. 10.4055/jkoa.2010.45.6.496.

Treatment of a Segmental Ulnar Shaft Fracture and an Olecranon Fracture

• Kim MS
• Moon KP
• Cho HJ
• Bae JY
• Suh KT

• KMID: 2185499
• DOI: http://doi.org/10.4055/jkoa.2010.45.6.496

Abstract

We would like to report a case of treating a segmental fracture of ulnar shaft, with a concomitant olecranon fracture. The patient was treated using tension band wiring and intramedullary nailing procedures. Based on the nature of the olecranon, we believe this should be a recommended treatment method that minimizes complications for the patient that has multiple fractures and a dislocation of the forearm.

Keyword

multiple forearm fractures; intramedullary nailing; tension band wiring

MeSH Terms

Dislocations
Forearm
Fracture Fixation, Intramedullary
Humans
Olecranon Process

Figure

• 

  Figure 1 Preoperative radiographs showed segmental fracture of ulnar shaft, olecranon fracture and radial shaft fracture with dislocation of radial head.

• 

  Figure 2 Postoperative radiographs showed olecranon fracture fixed with tension band wiring, and ulnar and radial shaft fractures fixed with contoured intramedullary nails.

• 

  Figure 3 Radiographs of postoperative 10 months showed complete union but heterotophic ossification occurred on tip area of olecranon and below of medial epicondyle (White arrow).

• 

  Figure 4 The patient underwent removal of heterotopic ossification & release of anterior and posterior capsule, adhesive tendon and muscle. Postoperative radiographs showed removal of heterotopic ossification.

• 

  Figure 5 All implants were removed at 19 months after operation.

Reference

1. Kim BH, Song MH, Ahn SJ, Yoo SH, Lee MS. Multiple fractures of forearm both bones: a case report of 5 separate sites. J Korean Fract Soc. 2005. 18:466–469.

2. Morrey BF. Current concepts in the treatment of fractures of the radial head, the olecranon, and the coronoid. Instr Course Lect. 1995. 44:175–185.

3. Ahn EH, Lee ST, Koo JH. Operative treatment of diaphyseal fractures of both forearm bones in adults. J Korean Soc Fract. 2001. 14:245–252.

4. Anderson LD, Sisk D, Tooms RE, Park WI 3rd. Compression-plate fixation in acute diaphyseal fractures of the radius and ulna. J Bone Joint Surg Am. 1975. 57:287–297.

5. Crenshaw AH, Perez EA. Canal T, Beaty JH, editors. Fractures of the shaft of the radius and ulna in adults. 2008. Philadelphia: Mosby;3425–3441.

6. Shim JI, Kim TS, Lee SJ, et al. Treatment of diaphyseal fractures of the forearm both bones. J Korean Soc Fract. 2000. 13:1016–1023.

7. Lee YH, Lee SK, Chung MS, Baek GH, Gong HS, Kim KH. Interlocking contoured intramedullary nail fixation for selected diaphyseal fractures of the forearm in adults. J Bone Joint Surg Am. 2008. 90:1891–1898.

8. Weckbach A, Blattert TR, Weisser Ch. Interlocking nailing of forearm fractures. Arch Orthop Trauma Surg. 2006. 126:309–315.

9. Gao H, Luo CF, Zhang CQ, Shi HP, Fan CY, Zen BF. Internal fixation of diaphyseal fractures of the forearm by interlocking intramedullary nail: short-term results in eighteen patients. J Orthop Trauma. 2005. 19:384–391.

10. Macko D, Szabo RM. Complications of tension-band wiring of olecranon fractures. J Bone Joint Surg Am. 1985. 67:1396–1401.