Clinical efficacy of posterior midline approach combined with anteromedial approach in the treatment of complex olecranon fracture-dislocation
10.3760/cma.j.cn121113-20250217-00146
- VernacularTitle:后正中联合前内侧入路治疗复杂尺骨鹰嘴骨折脱位的临床疗效
- Author:
Gang FENG
1
;
Zhihui XIANG
;
Deting XUE
;
Hang LI
;
Yanbin TAN
;
Yan WU
;
Yifan WU
;
CongYing SHEN
;
Yiying QI
Author Information
1. 浙江大学医学院附属第二医院，杭州 310009
- Publication Type:Journal Article
- Keywords:
Fractures, bone;
Olecranon process;
Dislocation;
Fracture fixation, internal
- From:
Chinese Journal of Orthopaedics
2025;45(13):840-847
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical efficacy of posterior midline incision combined with anteromedial approach in the treatment of complex olecranon fracture-dislocation.Methods:A retrospective analysis was performed on 26 patients (15 males and 11 females) with olecranon fracture-dislocation who were admitted from January 2020 to January 2024, including 5 cases of anterior transolecranon fracture-dislocation (2 cases of upper ulnar-radial joint dislocation), 21 cases of posterior transolecranon fracture-dislocation (5 cases of them were accompanied by upper ulnar-radial joint dislocation). Among them, there were 13 cases of traffic accidents, 7 cases of falling from heights, and 6 cases of walking falls. The average age is 45.1±15.3 years old (21-84 years old).Results:The operation time was 151.2±41.9 minutes, average tourniquet time was 93.7±22.6 minutes, and the intraoperative blood loss was 76.2±20.2 ml. The average follow-up was 16(12, 23) months, and the VAS score decreased significantly and the MEPS score increased significantly over time. At the last follow-up, the VAS score was 2(1, 2), and the MEPS score was 86.5±10.3, with 16 cases excellent, 7 cases good, and 3 cases medium, with an excellent rate of 89%. The range of motion of flexion-extension and pronation-supination were 119.3°±13.5°and 138.6°±15.2° respectively. Complications included 16 cases of ectopic ossification, of which 4 patients with significant effects on elbow function underwent surgical release 3-6 months after surgery. 1 case of ulnar nerve injury symptoms improved after emergency ulnar nerve release, and 1 case of elbow subluxation due to inaccurate coronoid process reduction and fixation. There were no serious complications such as vascular injury, internal fixation failure, fracture nonunion, and incision infection.Conclusion:The posterior midline incision combined with anteromedial approach can effectively treat complex olecranon fracture-dislocation and meet the requirements of early postoperative elbow rehabilitation.
