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.