title: Complex proximal ulna fractures: outcomes of surgical treatment.
abstract: BACKGROUND
  To review the results of plating of various fracture patterns of proximal ulna fractures including isolated olecranon fractures, olecranon fractures combined with a coronoid fracture, and olecranon fractures combined with a coronoid and radial head fracture.
  
  
  METHODS
  The study included 38 patients with either an isolated olecranon fracture or combined injuries, all treated with open reduction and internal fixation of the olecranon. Other procedures were performed as needed, including radial head fixation or arthroplasty, fixation of the coronoid, and repair of the lateral collateral ligament complex. There were 27 men and 11 women with an average age of 49 years. Clinical and radiographic assessment was obtained at an average follow-up time of 15 and 8.4 months, respectively.
  
  
  RESULTS
  All fractures healed within 5 months. The average arc of ulnohumeral motion was 91° (range 0°-140°); average pronation-supination arc was 128° (range 0°-180°). Subgroup analysis showed a statistically significant lower rotational motion arc in patients with associated radial head (73°) or coronoid fractures (68°) compared to isolated olecranon fractures. All other parameters including ulnohumeral motion, complication rate, and revision rate were similar among the groups.
  
  
  CONCLUSIONS
  A stable, functional elbow can be restored in most patients with proximal ulna fractures treated with open reduction and internal fixation. Loss of full flexion is likely with high-energy trauma, complex fracture patterns, and concomitant injuries. Fracture patterns involving the coronoid and/or the radial head are associated with restricted forearm rotation.
  
  
  METHODS
  III.
authors: Division of Hand Surgery, NYU Hospital for Joint Diseases, 550 First Avenue, New York, NY, 10016, USA, Eitanme2000@yahoo.com.
authors: Eitan
authors: E
authors: Melamed
authors: Natalie
authors: N
authors: Danna
authors: Monika
authors: M
authors: Debkowska
authors: Raj
authors: R
authors: Karia
authors: Frank
authors: F
authors: Liporace
authors: John T
authors: JT
authors: Capo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D056740:Olecranon Process / Q000293:injuries / Q000601:surgery; D011885:Radius Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery; D016059:Range of Motion, Articular; D020127:Recovery of Function; D016896:Treatment Outcome; D014458:Ulna Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery*; D055815:Young Adult