Reoperative Concerns in Fractures of the Radial Head and Proximal Ulna
Traditionally, proximal ulna and radius fractures have been underestimated as to their importance in providing stability and contributing to the long-term outcome of elbow fractures. Most of the research and clinical discussions have revolved around supracondylar injuries; however, the tight tolerances of elbow anatomy make it such that the olecranon, coronoid, and radial head also have important roles in reestablishing elbow function after injury. Most elbow surgeons now agree that the medial coronoid facet is very important to restore after trauma. Furthermore, the importance of the radial ulnar joint as well as the ulnohumeral joint cannot be underestimated to the long-term prognosis of elbow reconstruction after fracture. There are now a multitude of implant types, including the standard plating varieties with locked and unlocked screw options, as well as intramedullary devices. In recent years, there has been a development of several systems that can reestablish radial head anatomy as well as radial head replacements. The elbow surgeon now has more options than ever to help in the reconstruction of the patient’s elbow. However, despite all of these new tools, issues such as nonunion, malunion, posttraumatic arthritis, and continued instability may result. This chapter looks into those treatment options and identifies pearls that may be useful in both the primary and revision settings.
KeywordsOlecranon Fracture Coronoid Facet Ulnohumeral Radioulnar
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