Elbow Fractures and Dislocation-Case: Elbow Fractures and Dislocations Elbow

Case: Elbow Fractures and Dislocations Elbow

Pdf Summary

This document summarizes a clinical case example of a 70-year-old female patient who experienced a ground level fall. The injury pattern identified is a posterior Monteggia variant, with the proximal ulna and radial neck being injured. The plan for treatment includes reducing and plating the ulna fracture, as well as repairing or replacing the radial head. The bone is accessed through a posterior skin incision, either by working on the radial neck through the ulna fracture or through a separate deep incision using various approaches. Equipment needed includes an olecranon plate, radial head replacement, and hand cube or mini-fragment plates. The patient is placed in a supine position with the elbow draped over the chest, with an assistant holding the arm during most of the case. The ulna fracture and radial head replacement are exposed and provisionally plated. Intra-operatively, the patient remained stable and had good motion at four months post-surgery. The takeaway points from this case are to recognize the injury pattern as a posterior Monteggia injury, understand the specific pattern as a posterior Monteggia variant, know what needs to be repaired (ulna shaft and radial neck), and understand what does not need to be fixed (elbow ligaments, specifically the lateral collateral ligament complex).

Keywords

clinical case example

70-year-old female patient

ground level fall

posterior Monteggia variant

ulna fracture

radial head

treatment plan

skin incision

olecranon plate

radial head replacement