Olecranon and Radial Head Fractures: Is There Anything New?

Description

In this presentation, Adam Watts discusses the management and complexities of olecranon and radial head fractures, starting with a warm greeting and introductions. He outlines the key factors that affect treatment options, emphasizing the influence of age, comorbidities, and the nature of the fractures themselves. He presents compelling evidence that for older patients with low functional demands, non-operative management could be a feasible choice, albeit with the understanding that some will experience complications like elbow extension weakness or ongoing pain.



Watts also conducts an interactive session, asking participants to consider treatment options based on scenario-based radiographs, illustrating the divergence of opinions in surgical decisions, especially regarding techniques such as tension band wiring vs. plating. He shares a case where complications arose after surgical intervention, highlighting the potential pitfalls of operative management, particularly in frail patients.



Delving deeper, he explains critical indicators like the 'V sign' and the 'target sign' that signal the need for surgical intervention and plating in cases where instability is present. He reinforces the importance of detailed assessment and proper fracture alignment during surgery, introducing the 'four facet concept' of the greater sigmoid notch, which must be well-managed to ensure stable recovery.



Watts transitions to radial head fractures, noting the Mason classification and the variances in treatment based on fracture types and patient profiles. He underscores the importance of thorough clinical assessments including imaging as well as the potential benefits of arthroscopic management for certain scenarios. Closing his talk, he emphasizes not to underestimate the complexities associated with what may appear as simple injuries, reminding the audience of the crucial intraoperative assessments for optimal outcomes in elbow fracture management.

Specialties