DOI: https://doi.org/10.36347/sasjs.2026.v12i03.011

Pages: 226-230

Trans-olecranon fracture-dislocation (TOFD) of the elbow is an uncommon pattern of complex elbow trauma that is frequently misclassified as a Monteggia lesion. The purpose of this study was to describe the epidemiological profile, lesion pattern, surgical management, complications, and functional outcomes of patients treated for TOFD at a tertiary trauma center. We performed a retrospective case series of 13 patients managed between January 2020 and December 2024. Diagnosis was based on a very proximal metaphyseal ulna fracture associated with anterior displacement of the forearm on the lateral radiograph, with preservation of the proximal radioulnar relationship. All patients underwent surgical treatment and were followed clinically and radiographically for a mean of 18 months. Functional assessment was performed using the Broberg and Morrey score. The mean age was 26 years (range, 17-62 years), and 12 patients were male. The mechanisms of injury were falls in six cases, assaults in four, and road traffic accidents in three. Nine fractures were complex and four were simple. Associated injuries included three radial head fractures, one coronoid fracture, and five open fractures. Ten patients were treated by plate osteosynthesis and three by tension-band wiring. Physiotherapy was started 15 days after surgery. Complications included one case each of nonunion, secondary displacement, and elbow extension stiffness. According to the Broberg and Morrey score, outcomes were excellent in four patients, good in four, fair in three, and poor in two. TOFD remains a rare but severe injury. Favorable outcomes depend on early recognition, anatomical restoration of the trochlear notch, stable internal fixation, and timely rehabilitation.