Safe Zone for Anterior Cortical Perforation of the Ulna During Tension-Band Wire Fixation: A Magnetic Resonance Imaging Analysis
Document Type
Article
Publication Date
2008
Abstract
Placing K-wires obliquely through the anterior ulnar cortex is a common modification of traditional olecranon tension-band wiring. Wire tip protrusion, however, risks injury to adjacent neurovascular structures and may impede forearm rotation. This study examines the proximity of neurovascular structures to the anterior proximal ulnar cortex. The anatomy of 47 adult elbows was examined through magnetic resonance imaging. A radiologist measured the spatial relationship of 6 neurovascular structures to a mid-sagittal reference point 1.5 cm distal to the coronoid on the anterior surface of the ulna. Distance and angular measurements were made in the transverse plane of the reference point. Within a reasonable arc of K-wire placement, the ulnar artery and median nerve were at greatest risk yet were still beyond 10 mm from the anterior ulnar cortex. To avoid iatrogenic neurovascular injury during tension-band wiring of the olecranon, protrusion of wire tips beyond the anterior ulnar cortex should be no more than 1 cm at a distance of 1.5 cm distal to the coronoid.
Repository Citation
Prayson, M. J.,
Iossi, M. F.,
Buchalter, D.,
Vogt, M.,
& Towers, J.
(2008). Safe Zone for Anterior Cortical Perforation of the Ulna During Tension-Band Wire Fixation: A Magnetic Resonance Imaging Analysis. Journal of Shoulder and Elbow Surgery, 17 (1), 121-125.
https://corescholar.libraries.wright.edu/orthopaedics/116
DOI
10.1016/j.jse.2007.04.010
