Gigli saw; chevron osteotomy; distal humeral fracture; elbow fracture; olecranon osteotomy; surgical technique. Olecranon Osteotomy Bryan R.S., Morrey B.F. Extensive posterior exposure of the elbow. Upper extremity of left ulna. J Orthop Trauma. From the medial border a part of the flexor carpi ulnaris arises; while to the lateral border the anconeus muscle is attached. It is situated at the upper (proximal) end of the ulna, one of the two bones in the forearm. The following is an excerpt from an article written by the designers explaining the two techniques. [Effectiveness comparison between the paratricipital approach and the chevron olecranon V osteotomy approach in the treatment of type C3 distal humeral fractures]. 2006 Mar;20(3):164-71. doi: 10.1097/00005131-200603000-00002. Surgical Treatment of Intra-Articular Distal Humeral Fractures by using a Combined Medial and Lateral Approach: An Anatomic Study. olecranon osteotomy had a 2.7 times higher chance of developing heterotrophic ossification of more than 10 mm (odd ratio [OR] 2.7). However, even the olecranon osteotomy approach failed to provide visualization of more than 40% of the distal humeral articular surface. Please enable it to take advantage of the complete set of features! It forms the most pointed portion of the elbow and is opposite to the cubital fossa or elbow pit. Chevron osteotomy of the olecranon during the posterior approach of the elbow joint has become universally common. It is bent forward at the summit so as to present a prominent lip which is received into the olecranon fossa of the humerus in extension of the forearm. The plate, proximal olecranon fragment, and extensor mechanism are retracted en bloc. Anteroposterior and lateral radiographs showing anatomic union of osteotomy site at 6 months postoperatively. USA.gov. Its base is contracted where it joins the body and the narrowest part of the upper end of the ulna. [7–9,14,15] TRAP approach, as defined by O’Driscoll et al.,[12] is an al- Case Presentation Our patient, a 42-year-old, right hand dominated female was brought to the trauma center after a history of a fall from the first floor of a building. Osteotomy of the olecranon is particularly valuable in the treatment of comminuted distal fractures of the humerus involving the articular surface. When the hand faces forward (supination) the olecranon faces towards the back (posteriorly). After fracture repair, the osteotomy fragments are reapproximated, and the plate is reattached to the distal fragment. By use of a standard posterior approach, a precontoured olecranon plate is applied to the olecranon and affixed with screws both proximally and distally to the planned osteotomy site. Its borders present continuations of the groove on the margin of the superior surface; they serve for the attachment of ligaments, viz., the back part of the ulnar collateral ligament medially, and the posterior ligament laterally. Tech Shoulder Elbow Surg. The olecranon / oʊ ˈ l ɛ k r ə n ɒ n / from the Greek olene meaning elbow and kranon meaning head is the large, thick, curved bony eminence of the ulna, a long bone in the forearm that projects behind the elbow.It forms the most pointed portion of the elbow and is opposite to the cubital fossa or elbow pit. Methods: QuickDASH (short version of the Disabilities of the Arm, Shoulder and Hand questionnaire) and Veterans RAND 12-Item Health Survey (VR-12) scores for patients treated with this technique were compared with those of patients treated with the standard chevron osteotomy method. Comminuted olecranon fracture in 45-year-old male. -, Gummesson C., Ward M.M., Atroshi I. VuMedi is a video education platform for doctors. the Olecranon Osteotomy techniques. Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Background: See this image and copyright information in PMC. Plan of ossification of the ulna. Fractures of the olecranon are common injuries. The olecranon prevents over-extension of the elbow. Its posterior surface, directed backward, is triangular, smooth, subcutaneous, and covered by a bursa. A triceps-sparing approach. Because of the nonunion rate of 30% in our patients, we no longer use a transverse osteotomy of the olecranon to expose distal humerus fractures at surgery. 1% (29/3458) 2. 24 A thorough review of elbow anatomy and detailed approaches has been previously documented. From three centers. 2016 Aug;30 Suppl 2:S15-6. Osteotomy union was attained in all 5 cases, with functional outcomes comparable with those attained with the chevron technique. Orthop Surg. The known method osteotomy of the olecranon fractures of the distal part of the humerus (the Manual of internal fixation, Muller M.E. (JBJS Vol 82-A NO. The patients who had a fibrous nonunion of the ulnar osteotomy had an average extension lag of 27 degrees at the elbow, and all 3 patients had full flexion of the elbow joint. Background: Olecranon osteotomy is a commonly used method for obtaining adequate exposure of the articular surface in complex distal humeral fractures. Lateral aspect. This site needs JavaScript to work properly. Simple transverse olecranon fracture in 33-year-old female. Olecranon osteotomy exposed more articular surface than the triceps splitting approach (Mann-Whitney test, P =.03) but was not significantly greater than the triceps reflecting approach. 1952;83:265–270. Epub 2019 Jun 17. We modified the technique to see if it is better than the standard technique to perform, reconstruct and finally evaluate the results. Clin Orthop Relat Res. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. 21 Regarding olecranon osteotomy fixation methods, Coles et al. The osteotomy is fixed with a screw or tension band fixation. Olecranon osteotomy is the most frequently preferred sur-gical approach that provides excellent exposure. 2000;1:61–66. Over 250,000 doctors use VuMedi to improve patient care and grow their practice. Olecranon osteotomy. Conclusion: The combined olecranon osteotomy with posterior minimal plate osteosynthesis (MIPO) described herein provides a reliable method for the treatment of these complex fractures. A precontoured olecranon plate is affixed to the olecranon. Fixation of an olecranon osteotomy used for distal humerus surgery in a 24-year-old male. doi: 10.1097/BOT.0000000000000585. Olecranon Osteotomy With Tension Band Wire Repair. A prospective study was done in 17 cases of comminuted distal humeral intercondylar fractures. BMC Musculoskelet Disord. The osteotomy is created by directing the Gigli saw distally, and the cut…. Ann Med. Capsule of elbow-joint (distended). The olecranon / oʊ ˈ l ɛ k r ə n ɒ n / from the Greek olene meaning elbow and kranon meaning head is the large, thick, curved bony eminence of the ulna, a long bone in the forearm that projects behind the elbow.It forms the most pointed portion of the elbow and is opposite to the cubital fossa or elbow pit.

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