Surgical Discussion

Patient positioning:  The patient was positioned in a lateral decubitus position to allow optimal access to the posterior aspect of the elbow.

Anatomical surgical approach:  A posterior approach to the elbow was utilized, involving a midline incision over the olecranon extending distally along the subcutaneous border of the ulna. Subperiosteal dissection was performed to expose the fracture site for reduction and fixation.

The surgeon noted that with anatomic reduction of the proximal ulna, the radiocapitellar joint reduced spontaneously. It was emphasized that persistent dislocation of the radiocapitellar joint post-fixation often indicates inadequate reduction of the ulna, necessitating reassessment and correction of the ulnar alignment.

Postoperative protocol:   Postoperative rehabilitation included early mobilization with a focus on regaining range of motion. Weight-bearing restrictions were applied until radiographic evidence of fracture healing was observed.

Follow up:   Not specified.

Orthopaedic implants used:   Orthopaedic implants used included a plate and screw construct for fixation of the proximal ulna fracture.