Outcomes and challenges in the surgical treatment of trans-olecranon fracture-dislocations: A case series study
Abstract
Introduction Transolecranon fracture-dislocations represent a complex subset of elbow injuries characterized by concomitant fractures of the olecranon, coronoid process, and radial head, often associated with posterior dislocation. These injuries pose significant surgical challenges due to their inherent instability and high risk of poor functional outcomes. Despite previous studies describing different fixation techniques, there is no standardized surgical protocol to optimize outcomes. This study aims to evaluate the clinical and functional results of a structured surgical approach in the management of these injuries. Methods A retrospective case series was conducted, analyzing 12 patients with transolecranon fracture-dislocations treated at two orthopedic centers. Patients underwent open reduction and internal fixation (ORIF) using a standardized fixation sequence through the Wrightington posterolateral approach, with selective use of the anteromedial approach when necessary. Functional outcomes were assessed using the Mayo Elbow Performance Score (MEPS), Disabilities of the Arm, Shoulder, and Hand (DASH) score, and the Oxford Elbow Score (OES) at 2, 6, 12, and 24 months postoperatively. Radiographic follow-up included evaluation of bone healing, joint congruence, and post-traumatic arthritis. Statistical analysis was performed using repeated-measures ANOVA to assess functional improvement over time. Results At a mean follow-up of 24 months, significant improvement in…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 12 participants or records.
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