JBJS essential surgical techniques · 2015
Crista Supinatoris Fractures of the Proximal Part of the Ulna: Surgical Technique.
СтатьяНазвание и аннотация: Перевод в очереди
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Desloges William, Athwal George S, Elkinson Ilia, King Graham J W, Faber Kenneth J
Аннотация
INTRODUCTION: Open reduction and internal fixation of crista supinatoris fractures is required when the elbow is unstable despite appropriate nonoperative management and when a patient is undergoing surgical treatment of a periarticular elbow fracture-dislocation.
STEP 1 SKIN INCISION AND SURGICAL APPROACH: Use a posterior or lateral skin incision according to your preference and then utilize the Kocher interval to access the joint, lateral collateral ligament, and crista supinatoris or, in the setting of a proximal ulnar fracture, use the Boyd interval.
STEP 2 MANAGEMENT OF ASSOCIATED INJURIES: Crista supinatoris fractures have not been identified in isolation; address associated injuries such as radial head/neck fractures, capitellar fractures, and coronoid fractures first.
STEP 3 EVALUATION OF ELBOW STABILITY: If elbow instability persists after the concomitant injuries have been addressed, fix the crista supinatoris.
STEP 4 EXPOSURE OF THE CRISTA SUPINATORIS: Expose the fracture fragment and base of the crista supinatoris.
STEP 5 REDUCTION AND FIXATION OF THE CRISTA SUPINATORIS FRACTURE: Obtain an anatomic reduction and fixation of the crista supinatoris fracture to appropriately tension the lateral ulnar collateral ligament.
STEP 6 REEVALUATION OF ELBOW STABILITY: Gently evaluate the stability of the elbow following repair of the crista supinatoris fracture.
STEP 7 POSTOPERATIVE CARE: Initiate rehabilitation on the basis of intraoperative stability and concomitant injuries.
RESULTS: We recently conducted a retrospective review of the outcomes of twelve patients with a fracture of the crista supinatoris.IndicationsContraindicationsPitfalls & Challenges.
STEP 1 SKIN INCISION AND SURGICAL APPROACH: Use a posterior or lateral skin incision according to your preference and then utilize the Kocher interval to access the joint, lateral collateral ligament, and crista supinatoris or, in the setting of a proximal ulnar fracture, use the Boyd interval.
STEP 2 MANAGEMENT OF ASSOCIATED INJURIES: Crista supinatoris fractures have not been identified in isolation; address associated injuries such as radial head/neck fractures, capitellar fractures, and coronoid fractures first.
STEP 3 EVALUATION OF ELBOW STABILITY: If elbow instability persists after the concomitant injuries have been addressed, fix the crista supinatoris.
STEP 4 EXPOSURE OF THE CRISTA SUPINATORIS: Expose the fracture fragment and base of the crista supinatoris.
STEP 5 REDUCTION AND FIXATION OF THE CRISTA SUPINATORIS FRACTURE: Obtain an anatomic reduction and fixation of the crista supinatoris fracture to appropriately tension the lateral ulnar collateral ligament.
STEP 6 REEVALUATION OF ELBOW STABILITY: Gently evaluate the stability of the elbow following repair of the crista supinatoris fracture.
STEP 7 POSTOPERATIVE CARE: Initiate rehabilitation on the basis of intraoperative stability and concomitant injuries.
RESULTS: We recently conducted a retrospective review of the outcomes of twelve patients with a fracture of the crista supinatoris.IndicationsContraindicationsPitfalls & Challenges.