Essex Lopresti ORIF

History: 53 year-old male presented to the hospital after falling from a roof.  He had a severe injury to his right elbow and pain at his wrist. X-rays showed an intra-articular radial head fracture as well as a dislocation of the distal radioulnar joint at the wrist, also known as an Essex-Lopresti injury.  I recommended surgical fixation. 

Diagnosis: Right radial head fracture with DRUJ dislocation (Essex Lopresti)

Treatment: Right radial head ORIF with DRUJ pinning

Outcome: After a few months the pins were removed from his wrist and he regained full motion.  By 5 months he was swinging an axe again and had returned to full work without any restrictions.  

 

Olecranon Sled

History: 47 year old woman sustained an elbow injury when she was hit by a car while riding her bicycle.  She went to urgent care and was found to have an olecranon (elbow) fracture.  As a yoga instructor, it was very important to her that any treatment would allow her to continue doing yoga and would not irritate her elbow when doing a “plank” or other positions. 

Diagnosis: Right olecranon fracture

Treatment: Olecranon open reduction and internal fixation with a wireform sled and screws. Technique shown here.

Outcome: Within 3 weeks she had full motion and no pain.  The scar was fully healing and nearly invisible. She was very happy with the results. 

Olecranon ORIF Plate

History: 79 year old gentleman sustained an elbow injury when he fell from his bicycle.  He went to the emergency department where he was diagnosed as having an olecranon fracture.  I met him in the emergency department to discuss surgery. 

Diagnosis: Right olecranon fracture

Treatment: Olecranon open reduction and internal fixation with plates and screws

Outcome: Within 3 weeks hhe had near full motion and no pain.  The scar was fully healed and nearly invisible. He was very happy with the results. 

Distal Humerus ORIF

History: 51 year-old male cyclist who was hit by a car and came to the hospital as a trauma. He was found to have a severe elbow injury consisting of a comminuted intra-articular fracture of the distal humerus at the elbow. Based on the severe injury I recommended fixation.

Diagnosis: Right complex intra-articular distal humerus fracture

Treatment: Right humerus open reduction internal fixation with olecranon osteotomy

Outcome: He worked exceptionally hard with therapy and by 1 month was already doing better than expected. by 3 months he had nearly full strength and motion and was ready to get back on his bicycle. The incision healed up beautifully and was nearly invisible.

Olecranon Wireform ORIF

History: 75 year-old male who fell and injured his hip and elbow.  X-rays demonstrated a fracture of his olecranon at the elbow and he was indicated for surgery. 

Diagnosis: Left olecranon fracture

Treatment: Left olecranon open reduction internal fixation with plate and tension wire

 

Outcome: Within 3 months he was fully healed with nearly symmetric range of motion and full strength. 

Distal Humerus

History: 60 year-old male who injured his left elbow while riding his bicycle.  He went to the hospital where he was diagnosed with a severe fracture of the elbow that included the joint surface.  He he also had some arthritis in the elbow prior to his fall but it was not very bothersome to him. 

Diagnosis: Left complex distal humerus fracture 

Treatment: Left elbow open reduction internal fixation through an olecranon osteotomy

Outcome: His recovery was very smooth. Within a few weeks he was already using his arms for crutches and working on his range of motion. By 4 months after surgery he had near full motion with no pain. After 6 months he was fully healed. The incision was nearly invisible.