Clinical analysis of fractures around the elbow joint in adults

Cho, Duck Yun; Lee, Joong Myung; Kim, Hee Chun; Kim, Hyeong Jin

Abstract

The fractures around the elbow joint in adults are relatively rare in comparision with that in children, but the late complications are more common in adult. So, it is important to select the appropriate early management to prevent the late sequelae. Complications are joint contracture, persistant pain, nonunion, deformity, neurologic symptom, infection. etc. Among them limited range of joint motion is the main problem. We, authors have clinically and radiologically analyBed 48 cases of fracture around the elbow joint in adults over the age of 20 years, treated at the Department of Orthopaedic Surgery in National Medical Center from January 1984 through December 1993. The results are as follows: 1. The age incidence was higher in active young persons and the male to female ratio was 3:2. 2. The most common cause of the injury was slip-down(46%), followed by traffic accident(29fo), falling, and athletic injury. 3. In total 48 cases, olecranon fractures were 29 cases, fractures of distal humerus 13 cases, radial head fractures 5 cases, and multiple fractures (including olecranon, radial head and intercondyle) was 1 case, Among them. open fractures were 5 cases. 4. Closed reduction with cast immobilization or K-wire fixation was performed in 8 cases, and open reduction and internal fixation was performed in 37 cases. In 3 cases. radial head resection was done. 5. The most common complication was limited range of the joint motion (9cases), followed by nerve injury(3 cases), infection(3 cases) and nonunion(1 cases). 6. Development of limited range of joint motion was increased in case of old age over 60 years(33%), open fracture(60%), longer immobilization period over 6 weeks(27%). Though fracture around the elbow joint in adult is reletively rare. it frequently results in limitation of the joint motion and has poor prognosis For prevention of limitation of joint motion, rigid fixation and shortening of immobilization period and early rehabilitation are necessary.