Surgical Management of Radial Head and Proximal Ulna Fractures Without Elbow Dislocation: A Case Report

Abstract

Fractures involving the proximal ulna and radial head are common injuries that occur in the upper extremity, often resulting from traumatic incidents such as falls or direct impact. The proximal ulna forms the elbow joint with the humerus, while the radial head articulates with both the humerus and the ulna, facilitating forearm rotation. Fractures in these areas can disrupt the stability and function of the elbow joint, leading to pain, swelling, and limited range of motion. Clinically, it is more common to observe a radial head dislocation with a proximal ulna fracture. This fracture is referred to as a Monteggia fracture-dislocation. A radial head fracture and proximal ulna fracture occurring independently are not frequently encountered. In this study, we aim to discuss the surgical intervention performed on a patient with fractures of the proximal ulna and radial head, as well as the postoperative physical therapy follow-up.

Keywords: distal radioulnar joint (druj); monteggia's fracture; proximal ulna fracture; radial head fracture; radial head prosthesis.

Figure 1. X-ray images of the patient at hospital admission. Both anteroposterior (A) and lateral (B) X-ray images confirm a fracture at proximal ulna and radius

White arrows indicate the fracture site at proximal ulna and radius.

Figure 2. Sagittal section of the computed tomography images of the patient. Radial head fracture with subluxation (A) and proximal ulna fracture (B) can be seen in the tomography sections

White arrows indicate the fracture at the proximal ulna.

Figure 3. Axial section of the computed tomography images of the patient. Both A and B demonstrate the fracture in the radial head

White arrows indicate the fracture at proximal radius.

Figure 4. Coronal section of the computed tomography images of the patient. A and B demonstrate the fractures at the proximal ulna and radial head subluxation

White arrows indicate the fractures at proximal ulna and radius.

Figure 5. Postoperative X-ray images of the patient can be seen on the anteroposterior (A) and the lateral (B) view

White arrows indicate the implant after surgery.

Figure 6. The patient's ninth-month follow-up radiographs: (A) anteroposterior (AP) view, (B) oblique view, and (C) lateral view are shown

Figure 7. The patient's ninth-month follow-up physical examination findings: (A) a 10-degree loss of supination is observed; (B) pronation is observed to be complete; (C) flexion is observed to be complete; (D) supination restriction is noted