Vol. 10, Issue 4 (2024)

Introduction: Proximal ulna fractures is an umbrella term for a wide spectrum of injuries, ranging from simple fragility fractures to high energy complex trauma. This term includes fractures involving the ulno-trochlear joint (Olecranon & coronoid) and the proximal radioulnar joint. This study was to report the clinical and radiological outcome following treatment with proximal ulnar fracture by proximal ulnar locking plate including olecranon and Monteggia fractures.
Methods: This prospective study was hospital based and was conducted at Department of Orthopedic Surgery, BSMMU, Dhaka, Bangladesh from June 2022 to July 2023. In our prospective study, 25 patients with comminuted olecranon fracture and 10 patients with Monteggia fracture were treated using locking plate fixation. Patients were selected from those who attended the emergency and outpatient department. The patients were followed for clinical and radiological examination for minimum 6 months post operatively. Validated patient-oriented assessment scores involving the Mayo Elbow Performance Score (MEPS) and postoperative range of motion and patient's satisfaction were evaluated.
Results: The mean arc of elbow motion in 25 cases of olecranon fractures was 108° and mean MEPS was 89.3 with 57% excellent and 43% good results. While in 10 cases of Monteggia fractures mean arc of motion was 108° and mean MEPS were 93.8 with 89% excellent and 11% good results. All patients achieved fracture union by 24 weeks. Mean duration of fracture union for olecranon fractures was 16.1 weeks and for Monteggia fractures 14.3 weeks.
Conclusion: Locking plate is an effective fixation method for fractures of the proximal ulna allowing reliable stability for early elbow motion. The functional results are comparable with formerly described plating systems. The good radiological outcomes highlight the usefulness of plate fixation in cases of proximal ulna fractures, provided optimal plate positioning achieved.