Apparent Proximal Ulna Dorsal Angulation Variation Due to Ulnar Rotation

A 25-year-old woman presented to the emergency room with a painful and swollen right forearm. She had just sustained an injury from an accident during which her arm was tightly wound by a rope as she was lowering a net from a fishing boat. Before being released, her arm was rigidly trapped in the rope for approximately ten minutes. Radiographs revealed anterior dislocation of the radial head that was accompanied by plastic deformation of the proximal ulna, manifested as a reversal of the proximal dorsal angulation of the ulna (PUDA); suggested a Monteggia equivalent fracture. With the patient under general anesthesia, we reduced the radial head by posterior compression at 90° of elbow flexion and at neutral rotation of the forearm. However, the reduction was easily lost and the elbow re-dislocated with even slight supination or extension of the arm. After the osteotomy of the ulnar deformity to restore the PUDA to normal, the reduction remained stable even with manipulation of the arm. We found that the patient could exercise a full range of motion without pain at the 3-month follow-up, and neither residual instability nor degenerative changes were observed at the final 3-year follow-up.

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Evaluation of the Proximal Ulna Dorsal Angulation for Ulnar Component Sizing in Elbow Prosthetic Reconstruction After Distal Humeral Resection of Tumor

JAAOS Global Research and Reviews ◽

10.5435/jaaosglobal-d-20-00062 ◽

2020 ◽

Vol 4 (5) ◽

pp. e20.00062

Author(s):

Caleb M. Yeung ◽

Jonathan Lans ◽

Joseph B. Kuechle ◽

Zachary Wright ◽

Connie Y. Chang ◽

...

Keyword(s):

Proximal Ulna ◽

Prosthetic Reconstruction ◽

Component Sizing ◽

Dorsal Angulation

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Injuries to the Coronoid Process of the Ulna with Involvement of the Lesser Sigmoid Notch

Zeitschrift für Orthopädie und Unfallchirurgie ◽

10.1055/a-1263-1742 ◽

2020 ◽

Author(s):

Valentin Rausch ◽

Sina Neugebauer ◽

Tim Leschinger ◽

Lars Müller ◽

Kilian Wegmann ◽

...

Keyword(s):

Fragment Size ◽

Coronoid Process ◽

Annular Ligament ◽

Concomitant Injuries ◽

Proximal Ulna ◽

Sigmoid Notch ◽

Coronoid Fractures ◽

The Mean ◽

The Stability ◽

Arthritic Changes

Abstract Introduction This study aimed to describe the involvement of the lesser sigmoid notch in fractures to the coronoid process. We hypothesized that injuries to the lateral aspect of the coronoid process regularly involve the annular ligament insertion at the anterior lesser sigmoid notch. Material and Methods Patients treated for a coronoid process fracture at our institution between 06/2011 and 07/2018 were included. We excluded patients < 18 years, patients with arthritic changes or previous operative treatment to the elbow, and patients with concomitant injuries to the proximal ulna. In patients with involvement of the lesser sigmoid notch, the coronoid height and fragment size (anteroposterior, mediolateral, and craniocaudal) were measured. Results Seventy-two patients (mean age: 47 years ± 17.6) could be included in the study. Twenty-one patients (29.2%) had a fracture involving the lateral sigmoid notch. The mean anteroposterior fragment length was 7 ± 1.6 mm. The fragment affected a mean of 43 ± 10.8% of the coronoid height. The mean mediolateral size of the fragment was 10 ± 5.0 mm, and the mean cranio-caudal size was 7 ± 2.7 mm. Conclusion Coronoid fractures regularly include the lesser sigmoid notch. These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.

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Dynamic Proximal Ulnar Osteotomy for the Treatment of Ununited Anconeal Process in 17 Dogs

Veterinary and Comparative Orthopaedics and Traumatology ◽

10.1055/s-0038-1632614 ◽

1998 ◽

Vol 11 (02) ◽

pp. 76-79 ◽

Cited By ~ 14

Author(s):

B. M. Turner ◽

R. H. Abercromby ◽

J. Innes ◽

W. M. McKee ◽

M. G. Ness

Keyword(s):

Clinical Outcome ◽

Prospective Study ◽

Patient Population ◽

Clinical Results ◽

Radiographic Evaluation ◽

Proximal Ulna ◽

Ulnar Osteotomy ◽

A Prospective Study

SummaryA prospective study was made of 17 dogs with ununited anconeal process treated by osteotomy of the proximal ulna. The effect of the surgery on lameness was evaluated subjectively and the elbows were assessed radiographically for evidence of anconeal fusion and healing of the osteotomy. Whilst clinical outcome was generally good and complications infrequent, relatively few cases achieved anconeal fusion. These results do not compare well with the results of a previous study but this disparity may be due in part to differences in patient population and radiographic evaluation.Further work is required to establish how best to achieve predictable anconeal fusion.Proximal ulnar osteotomy was used to treat 17 dogs with ununited anconeal process. Clinical results were good but anconeal fusion was not achieved consistently. Further work is needed to determine how best to achieve predictable anconeal fusion.

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Do irradiated osteo-articular recycled tumor autografts still hold promise for biological joint reconstruction? Our experience with acetabular and proximal ulna ECRT

Journal of Clinical Orthopaedics and Trauma ◽

10.1016/j.jcot.2020.12.011 ◽

2020 ◽

Author(s):

Manit K. Gundavda ◽

Ashik Bary ◽

Manish G. Agarwal

Keyword(s):

Proximal Ulna ◽

Joint Reconstruction

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First-ever intraosseous ancient schwannoma of the proximal ulna successfully treated using the cement technique

Journal of International Medical Research ◽

10.1177/0300060520987732 ◽

2021 ◽

Vol 49 (2) ◽

pp. 030006052098773

Author(s):

Kai Xuan Lim ◽

Karl Wu

Keyword(s):

Rare Case ◽

Pathological Fracture ◽

Soft Tissue Neoplasm ◽

Proximal Ulna ◽

Intraosseous Schwannoma ◽

First Case ◽

Primary Bone ◽

Primary Bone Tumours ◽

Current Report ◽

Neural Sheath

Schwannoma or neurilemmoma is a common soft tissue neoplasm arising from the neural sheath of Schwann cells. However, intraosseous schwannoma is rare, accounting for less than 0.2% of primary bone tumours. Several variants of schwannoma have been reported; among them, intraosseous schwannoma with ancient change is extremely rare. This current report presents an extremely rare case of ancient intraosseous neurilemmoma. The patient presented with right elbow pain and disability. A radiolucent, well-defined, lobulated lesion with a thin sclerotic rim in the proximal ulnar metaphysis that had caused a pathological fracture was noted. The mass was surgically excised using marginal resection and bone curettage was undertaken. The bone deficit was grafted with hydroxyapatite and β-tricalcium phosphate and augmented with bone cement. There were no signs of any recurrence after 3 years. This is the first case of an ancient intraosseous schwannoma of the proximal ulna. Although rare, intraosseous schwannoma should be considered in the differential diagnosis of radiographically benign-appearing osseous tumours in the bone. The cement technique is recommended for the treatment of intraosseous schwannoma.

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