Description
This presentation by Andrew Duckworth focuses on complex proximal ulnar fractures, a challenging injury often encountered in orthopedic surgery. Duckworth begins by discussing the Mayo classification but suggests that the Wrightington classification is more effective for guiding management. He emphasizes the importance of the coronoid in these fractures, often referred to as 'malignant injuries' due to their potential for complications. Duckworth outlines two major types of fracture dislocations—Monteggia fractures and transolecranon dislocations—and provides clinical examples to highlight the nuances of diagnosis and treatment. He stresses the necessity of thorough imaging, particularly CT scans, in assessing these injuries to ensure comprehensive planning for surgical intervention. Duckworth discusses various surgical approaches to address these complex fractures, including the importance of repairing the coronoid and lateral ligaments when applicable. He underlines that outcomes for these injuries can be poor, regardless of surgical skill, and warns of high risks for complications like post-traumatic stiffness. In conclusion, Duckworth reiterates that understanding the fracture pattern and proper management of the coronoid are pivotal in improving patient outcomes.