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Volume 5
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10.3390/surgeries5030048
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Article

The Trans-Olecranon Approach for a Concomitant Radial Head Arthroplasty and Internal Fixation of the Ulna in Monteggia-Equivalent Fractures

by
David Shaked Zari
1,*,
Itay Ron
1,
Doron Norman
1,2,
Jihad Dabbah
1,2,
Bezalel Peskin
1,2,
Nabil Ghrayeb
1,2 and
Jacob Shapira
1,2
1
The Ruth and Bruce Rappaport Faculty of Medicine, Technion Israel Institute of Technology, Haifa 3525433, Israel
2
Rambam Medical Center, Division of Orthopedic Surgery, Haifa 3525408, Israel
*
Author to whom correspondence should be addressed.
Surgeries 2024, 5(3), 609-618; https://doi.org/10.3390/surgeries5030048
Submission received: 29 June 2024 / Revised: 25 July 2024 / Accepted: 31 July 2024 / Published: 5 August 2024
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Abstract

Background: Monteggia-equivalent fractures are similar to Monteggia fractures but involve different patterns and locations. When these fractures include a severe radial head fracture, radial head arthroplasty (RHA) should be considered. RHA can be performed using Kocher’s approach or the less commonly used trans-olecranon approach, which has been less studied. This study evaluates the clinical and radiological outcomes of the trans-olecranon approach for RHA over 15 years. Methods: In this retrospective study, 45 cases of Monteggia-equivalent fractures were analyzed, focusing on patients over 18 with radial head fractures, treated by the same surgeon with RHA and open reduction and internal fixation (ORIF) of the proximal ulna via the trans-olecranon approach. Results: The cohort of 45 patients showed a mean flexion of 112.37° ± 13.7°, mean extension of 24.27° ± 17.9°, mean supination of 57.63° ± 28.9°, and mean pronation of 62.16° ± 29.07°. Clinical and radiographic measurements indicated satisfactory results, with acceptable complication and secondary procedure rates. Conclusion: The trans-olecranon, single-incision approach is effective for managing fractures involving the proximal ulna and radial head, offering adequate access to lateral elbow structures while minimizing damage to surrounding soft tissue. Therefore, this approach should be considered for patients presented with a Monteggia-equivalent fracture and an indication for RHA.
Keywords: radial head arthroplasty; Monteggia-like fractures; trans-olecranon approach radial head arthroplasty; Monteggia-like fractures; trans-olecranon approach

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MDPI and ACS Style

Zari, D.S.; Ron, I.; Norman, D.; Dabbah, J.; Peskin, B.; Ghrayeb, N.; Shapira, J. The Trans-Olecranon Approach for a Concomitant Radial Head Arthroplasty and Internal Fixation of the Ulna in Monteggia-Equivalent Fractures. Surgeries 2024, 5, 609-618. https://doi.org/10.3390/surgeries5030048

AMA Style

Zari DS, Ron I, Norman D, Dabbah J, Peskin B, Ghrayeb N, Shapira J. The Trans-Olecranon Approach for a Concomitant Radial Head Arthroplasty and Internal Fixation of the Ulna in Monteggia-Equivalent Fractures. Surgeries. 2024; 5(3):609-618. https://doi.org/10.3390/surgeries5030048

Chicago/Turabian Style

Zari, David Shaked, Itay Ron, Doron Norman, Jihad Dabbah, Bezalel Peskin, Nabil Ghrayeb, and Jacob Shapira. 2024. "The Trans-Olecranon Approach for a Concomitant Radial Head Arthroplasty and Internal Fixation of the Ulna in Monteggia-Equivalent Fractures" Surgeries 5, no. 3: 609-618. https://doi.org/10.3390/surgeries5030048

APA Style

Zari, D. S., Ron, I., Norman, D., Dabbah, J., Peskin, B., Ghrayeb, N., & Shapira, J. (2024). The Trans-Olecranon Approach for a Concomitant Radial Head Arthroplasty and Internal Fixation of the Ulna in Monteggia-Equivalent Fractures. Surgeries, 5(3), 609-618. https://doi.org/10.3390/surgeries5030048

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