Open transverse olecranon fracture accompanied with ulnar nerve injury:analysis of surgical treatment results

Objectives To evaluate the surgical results of open transverse olecranon fracture accompanied with ulnar nerve injury. Methods Twenty-one cases of open transverse olecranon fracture with ulna nerve injury treated from August 2003 to June 2007 were retrospectively analyzed. All fractures were treated by AO cannulated screws plus traditional tension band fixation. The ulnar nerves were repaired by end-te-end epineurial neurorrhaphy and anterior subcutaneous transposition. Early functional exercise started two weeks after the operation. Results Eighteen cases were followed up for 12 to 19 months with an average period of 13 months. The elbow joint function was evaluated with Breberg-Morrey grading system. Results of treatment were graded as excellent in 14 cases, good in 3 cases, and poor in 1 case. The overall good-excellent rate was 94.0%. The surgical results of ulnar nerve were evaluated by the sensory (S) and motor (M) grading system published by Medical Council of Britain. Results were excellent ( M4 S3 ) in 6 cases, good (M3S3) in 10 cases, fair (M2S2) in 1 case, and poor(M1S1) in 1 cases. The good-excellent rate was 88.9%. Conclusion Open transverse olecranon fracture with ulnar nerve injury should be treated by reliable internal fixation and repair and anterior subcutaneous transposition of the ulnar nerve. Assisted with early functional exercise, this surgical procedure can lead to satisfactory results. Key words: Ulna fractures;  Fractures,open;  Fracture fixation,internal;  Ulnar Nerve