title: Fracture-dislocations of the proximal ulna.
abstract: OBJECTIVE
  To investigate the relationship between injury patterns, complications, and the functional outcomes of patients with proximal-ulna fracture-dislocations.
  
  
  METHODS
  Retrospective analysis of 15 patients (10 men, 5 women; mean age, 49.1 years; mean follow-up 49 months) with 6 anterior and 9 posterior fracture-dislocations of the proximal ulna. The proximal ulna was reconstructed with plates and screws in 13 patients and tension-band wiring in 2 patients. At the final follow-up, elbow range of motion (ROM) was measured and Mayo elbow scores (MEPS) were recorded. Broberg-Morrey criteria were used for osteoarthritis staging.
  
  
  RESULTS
  Concomitant radial-head fracture was seen in all posterior fracture-dislocations. Four ligamentous injuries occurred in this group. All anterior dislocations had trochlear-notch fractures without associated injuries. Mean flexion ROM was 130.6° (100°-140°) and mean loss of extension ROM was 12.6° (0°-30°) in the study group. The mean MEPS score was 92.3 (70-100). Patients with posterior fracture-dislocations showed lower ROM and MEPS and higher level of osteoarthritis than patients with anterior fracture-dislocations. Recurrent dislocations occurred in 2 patients who had ulna fractures fixed with tension-band wiring.
  
  
  CONCLUSIONS
  Radial-head fracture and ligamentous injury are specific components of posterior fracture-dislocations. The injury is limited to the trochlear notch in anterior fracture-dislocations. Posterior fracture-dislocations have lower functional outcomes. Proximal-ulna fractures should be fixed with rigid internal fixation (plate and screw) even if the fracture is a simple 2-part fracture.
authors.affiliation: Acıbadem University Faculty of Medicine, Department of Orthopaedics and Traumatology, İstanbul, Turkey. arelgereli@gmail.com.
authors.forename: Arel
authors.initials: A
authors.lastname: Gereli
authors.affiliation: Acıbadem University Faculty of Medicine, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
authors.forename: Ufuk
authors.initials: U
authors.lastname: Nalbantoğlu
authors.affiliation: Acıbadem Health Group Maslak Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
authors.forename: Göksel
authors.initials: G
authors.lastname: Dikmen
authors.affiliation: Acıbadem Health Group Kadıköy Hospital, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
authors.forename: Mustafa
authors.initials: M
authors.lastname: Seyhan
authors.affiliation: Acıbadem University Faculty of Medicine, Department of Orthopaedics and Traumatology, İstanbul, Turkey.
authors.forename: Metin
authors.initials: M
authors.lastname: Türkmen
mesh_terms: D000328:Adult; D000368:Aged; D004551:Elbow Joint / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000009:adverse effects*; D017102:Fracture Healing; D006801:Humans; D004204:Joint Dislocations / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011859:Radiography; D011885:Radius Fractures / Q000601:surgery*; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D014457:Ulna / Q000000981:diagnostic imaging*; D014458:Ulna Fractures / Q000601:surgery*; D000092464:Elbow Injuries