CURRENT CONCEPTS IN ADULTS UPPER EXTREMITY FRACTURES

21452Ugur_TiftikciCurrent_Consept_in_adults.kapak

PROXIMAL FOREARM FRACTURES:ANATOMY, EPIDEMIOLOGY AND CLASSIFICATION OF PROXIMAL ULNAR FRACTURES

Ahmet Günay Adam

Ankara Training and Research Hospital, Department of Orthopedics and Traumatology, Ankara, Türkiye

Adam AG. Proximal Forearm Fractures: Anatomy, Epidemiology and Classification of Proximal Ulnar Fractures. In: Tiftikçi U, Erdoğan E, Ergün C, Güneş Z, editors. Current Concepts in Adults Upper Extremity Fractures. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.145-149.

ABSTRACT

The proximal ulna is crucial for elbow joint stability and movement, encompassing three primary joints: the radioulnar, radiocapitellar, and ulnohumeral joints. The joint dynamics are facilitated by the small sigmoid notch and radial head, which form a pivot-type synovial joint, allowing for significant pronation and supination. Key stabilizing structures include the annular ligament that encircles the radial head and tightens during movement. Anatomically, the olecranon resides posteriorly, while the coronoid process is anterior, creating a hinge-type ulnohumeral joint that permits extensive flexion and extension. Research indicates that the ulnohumeral joint enables 130-154 degrees of flexion and has a cartilage-free area critical for surgical considerations. The coronoid process acts as a primary restraint against posterior dislocation, while the olecranon prevents anterior dislocation. Static stabilizers such as the medial collateral ligament and lateral complex play vital roles against valgus and varus stresses, respectively.

Proximal ulna fractures encompass coronoid and olecranon fractures, representing a significant percentage of forearm injuries, frequently arising from low-energy falls and more common in individuals over 70, often associated with osteoporosis. Classification systems for these fractures, including Colton, AO, and Mayo classifications, assist in treatment decisions and healing evaluations. Regan and Morrey’s classification of coronoid fractures emphasizes the fracture line’s position, while O’Driscoll’s approach introduces detailed anatomical considerations using computed tomography. Understanding the complexities of the proximal ulna’s anatomy and associated injuries is essential for effective diagnosis, management, and rehabilitation of elbow-related conditions.

Keywords: Olecranon; Coronoid process; Classification; Anatomy; Elbow joint

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