The Montecranon classification—a comprehensive treatment strategy for complex proximal ulna fracture dislocations

作者：Christian Spross, Michael Strässle, Jesse B. Jupiter, Roger van Riet, Alberto G. Schneeberger, Andrew M. Choo, Denise Eygendaal, Kutalmış Albayrak, Jonas Grossmann, Vilijam Zdravkovic, Bernhard Jost · 发表于：JSES International · 年份：2025 · DOI：10.1016/j.jseint.2025.07.008 · 被引用次数：2 · 研究领域：Elbow and Forearm Trauma Treatment、Orthopedic Surgery and Rehabilitation、Shoulder Injury and Treatment

Background: Complex proximal ulna fracture dislocations include Monteggia-like fractures and transolecranon fracture dislocations. Since 2011, we introduced a structured classification and treatment algorithm for these fractures in a Swiss teaching hospital, considering ligamentous structures, the coronoid process, and the radial head. This classification, named the Montecranon classification (MC), was validated by users with varying experience levels through a retrospective clinical analysis. Methods: All consecutive patients treated for a complex proximal ulnar fracture dislocation between 2011 and 2022 were retrospectively analyzed. Fractures were classified according to the Bado, Jupiter, Mayo, and the new MC.For the clinical study, patients treated according to the MC were retrospectively analyzed including final range of motion, EuroQol 5-Dimensions-5-Levels Score, Quick DASH, Mayo Elbow Performance Score, analysis of complications/revisions, and radiographic assessment for posttraumatic arthritis. Patients included had at least one year of clinical and radiographic follow-up.For validation, 22 randomly selected cases were sent to 4 elbow experts, 3 young consultants, and 3 novice doctors. Results: Of 43 patients (mean 55 years, range: 19-87) who suffered a complex proximal ulnar fracture dislocation, 30 patients met the inclusion criteria. Four patients (13%) had a transolecranon fracture dislocation, and 26 patients (87%) had a Monteggia-like fracture. The mean follow...