Surgical Discussion

Patient positioning:  The patient was positioned supine with the affected arm on a radiolucent hand table to facilitate access to the elbow and allow for intraoperative fluoroscopic imaging.

Anatomical surgical approach:  A posterior approach to the elbow was utilized. A midline incision was made over the olecranon, extending proximally and distally to allow adequate exposure of the fracture site and associated ligamentous structures. Subperiosteal dissection was performed to expose the olecranon fracture and facilitate reduction and fixation.

Intraoperatively, it was confirmed that the injury was a trans-olecranon fracture dislocation with significant ligamentous disruption. After fixation of the olecranon with appropriate hardware, repair of the lateral ulnar collateral ligament (LUCL), annular ligament, and medial and lateral joint capsules was performed to restore elbow stability. Fluoroscopic imaging demonstrated improved joint congruity and stability post-repair.

Postoperative protocol:   Postoperatively, the patient was placed in a splint with the elbow in extension. Early range of motion exercises were planned to commence 1-2 weeks post-surgery, contingent upon wound healing, to prevent stiffness and promote functional recovery.

Follow up:   Not specified.

Orthopaedic implants used:   Orthopaedic implants used included a small plate for provisional humeral stabilization and hardware for olecranon fixation (specific type not detailed).