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

Introduction: 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.

Step 1 Skin Incision And Surgical Approach: 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.

Step 2 Management Of Associated Injuries: Crista supinatoris fractures have not been identified in isolation; address associated injuries such as radial head/neck fractures, capitellar fractures, and coronoid fractures first.

Step 3 Evaluation Of Elbow Stability: If elbow instability persists after the concomitant injuries have been addressed, fix the crista supinatoris.

Step 4 Exposure Of The Crista Supinatoris: Expose the fracture fragment and base of the crista supinatoris.

Step 5 Reduction And Fixation Of The Crista Supinatoris Fracture: Obtain an anatomic reduction and fixation of the crista supinatoris fracture to appropriately tension the lateral ulnar collateral ligament.

Step 6 Reevaluation Of Elbow Stability: Gently evaluate the stability of the elbow following repair of the crista supinatoris fracture.

Step 7 Postoperative Care: Initiate rehabilitation on the basis of intraoperative stability and concomitant injuries.

Results: We recently conducted a retrospective review of the outcomes of twelve patients with a fracture of the crista supinatoris.IndicationsContraindicationsPitfalls & Challenges.