Fracture of Olecranon & Proximal ulna

소개

Fracture of Olecranon & Proximal ulna 에 관한 Campbell 및 Rockwood 정리본

목차

1. Introduction
2. Anatomy
3. Muscles Affecting the Elbow
4. Ligaments of the Elbow
5. Mayo Classification
6. Schatzker Classification
7. Method of operative Tx
8. Cases

본문내용

Elbow joint
Hinge joint
Composed of 3 articulations:
1. Humeroulnar joint : 힘과 안정성 유지
2. Humeroradial joint : 외반 스트레스에 저항력, 90도 굴곡시 후위 이동제어
3. Radioulnar joint : 요골의 내회전과 외회전을 허용

Mayo Classification
Type Ι : 비전위골절로서 분쇄가 없으며 2mm이하의 전위
Type ΙΙ : 전위성 안정성 골절, 3mm이상 전위가 있으나 측부인대가 보존되어 있음
Type ΙΙΙ : 전위성 불안정성 골절,골절 탈구를 동반한 상태



Conjunction with some form of medullary fixation
After Tx.
- post. splint is applied with elbow at 90°
- 7~10 days : gentle active and active-assisted ROM start
- 4wks : discontinued support
- maximal function may not return before 6-12month
IM fixation
Ix
1.olecranon is comminuted & its distal fragment and radial head dislocated anteriorly
2.ulnar shaft Fx.가 동반된 경우
Plate fixation(ΙΙΙB)
Longitudinal Fx.
- when comminuted, bone loss에 의한 olecranon shorting을 예방위해
- applied on post.surface & unicortical screw are used near the articular surface
J Bone Joint Surg Am. 2009;91:2416-2420
Excision of proximal fragment
Advantage
-Possibility of nonunion is eliminate
-Possibility of traumatic arthritis minimized

참고자료

· Fracture of Olecranon & Proximal ulna 에 관한 Campbell 및 Rockwood 정리본