Book contents
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Chapter 1
- Chapter 2
- Chapter 3
- Section I Fractures of the proximal ulna
- Section II Fractures of the ulnar shaft
- Section III Fractures of the distal ulna
- Chapter 4
- Chapter 5
- Chapter 6
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Section I - Fractures of the proximal ulna
from Chapter 3
Published online by Cambridge University Press: 05 February 2015
- Frontmatter
- Dedication
- Contents
- List of contributors
- Preface
- Acknowledgments
- Part I Upper extremity
- Chapter 1
- Chapter 2
- Chapter 3
- Section I Fractures of the proximal ulna
- Section II Fractures of the ulnar shaft
- Section III Fractures of the distal ulna
- Chapter 4
- Chapter 5
- Chapter 6
- Part II Pelvis and acetabulum
- Part III Lower extremity
- Part IV Spine
- Part V Tendon injuries
- Part VI Compartments
- References
- Index
Summary
TENSION BAND WIRING OF OLECRANON FRACTURES
Indications
Displaced transverse fractureof the olecranonwithdisruption of the extensor mechanism.
The technique can be used with caution in oblique or fragmented fractures once issues related to these fracture patterns are addressed.
Pre-operative planning
Clinical assessment
Mechanism of injury: forced extension usually following a fall. Beware of the high-energy fracture patterns that may suggest that the fracture is only a portion of the injury.
Findings: pain, swelling and occasionally impressive ecchymosis over the elbow region. Beware of injury to the soft tissue envelope that may interfere or preclude surgical intervention.
Findings: loss of active extension associated with displaced fractures. Beware of examination pitfall where passive gravity-assisted extension leads to the assumption of an intact extensor mechanism.
Findings: check for ulnar nerve impairmentandensure the injury is in isolation.
Radiological assessment
Anteroposterior and lateral radiographs of the elbow are the absolute minimum imaging requirement. Beware of more complex injuries that may need further imaging, most commonly in the formof a CT scan (Fig. 3.1).
Operative treatment
Anaesthesia
Regional/general.
Pre-operative administration of antibiotics (cephalosporin).
Prescrub and drying of the limb.
Tourniquet application, if there are no contraindications. Ensure the tourniquet does not interfere with the operative field and that no preparation solution leaks underneath. Inflate the tourniquet once the limb has been elevated for approximately 3 minutes.
- Type
- Chapter
- Information
- Practical Procedures in Orthopaedic Trauma Surgery , pp. 45 - 50Publisher: Cambridge University PressPrint publication year: 2006