APEX Elbow Mastering Surgical Techniques for Clinical Success-Complex Elbow Trauma

Video Transcription

Video Summary

The speaker leads a pragmatic, case-based discussion on complex elbow trauma, emphasizing subtle injuries, imaging choices, and fixation strategies. Case 1: a 39-year-old with elbow dislocation and radial head fracture. CT with 3D recon reveals an easily missed supinator crest (ulnar supinator ridge) fracture hidden on standard AP/lateral views. They discuss when to treat radial head fractures nonoperatively (no mechanical block; “type 2/1.5” often observed) versus fixation, and stress that the supinator crest fragment often needs fixation because the LUCL remains attached. Surgical pearls include posterior incision with separate windows, K-wires used as drills for small screws, and suture-anchor “hammock” fixation plus a compressive screw.<br /><br />Case 2: a 48-year-old “terrible triad” pattern. They debate coronoid fixation (speaker is aggressive, using suture-lasso) and radial head ORIF vs replacement, stressing LUCL repair and avoiding overstuffing.<br /><br />Final case: an unstable “simple” dislocation from pedestrian–car trauma with internal degloving. Posterior incision led to catastrophic skin necrosis due to disrupted perforators, teaching caution and considering temporizing stabilization (pins/ex-fix/bridge plate) when instability suggests severe soft-tissue injury.

Asset Caption

Moderator: William Aibinder, M.D.

Keywords

complex elbow trauma

supinator crest fracture

lateral ulnar collateral ligament (LUCL) repair

terrible triad elbow injury

radial head fracture ORIF vs arthroplasty

external fixation/temporizing stabilization