Fracture of the olecranon of the ulna
Content:
- What is an ulna fracture?
- What happens during an olecranon fracture?
- Symptoms of an olecranon fracture
- Diagnostics
- Treatment of a fracture of the olecranon of the ulna
- Effects
What is an ulna fracture?
Under the action of a sharp traumatic force, bone destruction occurs in the elbow region. Such injuries account for approximately 3.5% of the total number of skeletal bone fractures.
A fracture is formed most often when an unsuccessful fall on an arm that is set aside and bent at the elbow or when the process is struck.
Sometimes, for any reason, a sharp contraction of the triceps brachialis muscle can lead to a violation of the integrity of the protruding part of the bone tissue.
What happens during an olecranon fracture?
Almost always, the fracture occurs inside the joint. If there is no damage to the tendon in the area of the triceps muscle, then the broken off parts are displaced close and this is hardly noticeable. If a tendon ruptures, the muscle contracts and pulls the debris with it.
Fractures occur with simultaneous dislocation of the head, called Malgen damage.
Symptoms of an olecranon fracture
When examining a patient, the following signs are revealed:
- The damaged joint is deformed, its swelling is observed.
- Movement in this place is limited (extension does not occur completely).
- The joint has bleeding visible under the skin.
- During the probing of the appendix, the injured person feels pain.
- With a displaced fracture, the protruding part becomes sunken.
Pain syndrome forces the patient to hold the arm in a hanging position.
Diagnostics
Soreness is observed when probing the appendix. If there is a fracture with displacement, then between the fragments you can feel emptiness. When trying to bend the arm in the damaged area, pain is felt, which intensifies at the time of straightening. With no offset, the freedom of movement is slightly more.
X-ray examination is performed to determine the extent of the damage. And they do it in two projections. The first is the area of the forearm in its upper part, and the second is the place of attachment of the muscles of the humerus. This is done in order to find out if there was a rupture of the annular ligament with a displaced fracture.
It should be noted that in some patients in the damaged area, bone formations and sesamoid (unstable) bones are possible, and the epiphyseal cartilaginous plate occurs only in children and young people under 20 years of age.
Treatment of a fracture of the olecranon of the ulna
Plaster application
In the case of a fracture of the appendix without displacement, conservative treatment is prescribed. A plaster cast is applied to the injury site, which covers the third part of the shoulder (upper) together with the forearm (up to the wrist joint). The arm is bent at an angle of approximately 120 ° and so fixed.
For free joints, the doctor prescribes movements from the first days, and the damaged area begins to develop after 2 weeks. To do this, temporarily remove the bandage and make careful extension with a return to the previous position. Then the plaster is put in place.
In the same way, the treatment takes place if there is a displacement of the fragments, but insignificant. The hand is fixed in the position in which the fragments take their places. It takes 3 to 4 weeks for complete bone regeneration.
Operative intervention
With a strong displacement of the fragments, an operation is required. It is used if there is a distance of 2 mm or more between the fragments, or they are offset to the side. Surgical intervention is also required for fractures with multiple fragments. After determining the type of injury, the most appropriate treatment method is selected, in which it will be possible to start moving in the injured place as early as possible. To treat a fracture, osteosynthesis is used, that is, bones are fastened with two knitting needles and a titanium wire. The operation can be performed as soon as the patient is admitted to the department.
After anesthesia, an incision is made over the damaged area. Through it, all blood clots and very small bone particles are removed. The fragments are corrected relative to each other in the correct position using a single-tooth hook. Using a drill, two knitting needles are inserted. At a distance of at least 3 cm from the fracture, holes are drilled for pulling the wire holding the fragments together. The ends of the wire are twisted with pliers. Above the olecranon, no more than 2 cm of the length of the needles is left, the rest is bitten off. The ends are bent towards the bone.
The operated limb is fixed with a kerchief. After about 5 days, it is recommended to start moving your arm. Full rehabilitation of the motor ability occurs within 5 weeks.
The metal fasteners are removed under local anesthesia not earlier than after 3 months.
For fractures in which there is damage to Monteggi, osteosynthesis is carried out using a long nail. The radial head is pre-adjusted.
In case of crushing of the olecranon process and tearing of its top, all fragments are removed, and the tendon extension of the biceps is fixed. Fastening is carried out with the help of sutures in the area of the ulna, in which holes are drilled specially for this. Anchoring sutures are also made on the fascia and periosteum. After the operation, the arm is fixed for 3 weeks at an angle of approximately 155 0. Then comes the recovery period.
On the subject: 12 popular ways for home treatment
Effects
Incorrectly or poorly healed fractures can cause impaired motor functions. If the restoration of functions is not helped by a therapeutic rehabilitation complex, then in this case, surgical treatment is also used. Through a longitudinal incision, all fragments are returned to the correct position and fastened. If the process does not fit well, then the tendon is fixed.
Old age is not an obstacle to olecranon surgery. Its removal and the subsequent restoration of motor functions are also possible.
In case of a fracture, you must go to the clinic to a surgeon or traumatologist
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
