Crista Supinatoris Fractures of the Proximal Part of the Ulna: Surgical Technique.

Abstract

Open reduction and internal fixation of crista supinatoris fractures is required when the elbow is unstable despite appropriate nonoperative management and when a patient is undergoing surgical treatment of a periarticular elbow fracture-dislocation. Use a posterior or lateral skin incision according to your preference and then utilize the Kocher interval to access the joint, lateral collateral ligament, and crista supinatoris or, in the setting of a proximal ulnar fracture, use the Boyd interval. Crista supinatoris fractures have not been identified in isolation; address associated injuries such as radial head/neck fractures, capitellar fractures, and coronoid fractures first. If elbow instability persists after the concomitant injuries have been addressed, fix the crista supinatoris. Expose the fracture fragment and base of the crista supinatoris. Obtain an anatomic reduction and fixation of the crista supinatoris fracture to appropriately tension the lateral ulnar collateral ligament. Gently evaluate the stability of the elbow following repair of the crista supinatoris fracture. Initiate rehabilitation on the basis of intraoperative stability and concomitant injuries. We recently conducted a retrospective review of the outcomes of twelve patients with a fracture of the crista supinatoris.IndicationsContraindicationsPitfalls & Challenges.