摘要
目的探讨尺骨冠状突骨折复位固定对复杂肘关节骨折脱位术后维持肘关节稳定的意义。方法回顾性分析自2008-03—2013-07采用切开复位内固定治疗的17例复杂肘关节骨折脱位,术中对尺骨冠状突骨折进行复位固定。末次随访时按Mayo评分标准评定肘关节功能。结果本组17例均获得随访18~60个月,平均38个月。切口均一期愈合。所有患者术后12~24周骨折端获得临床愈合,前臂旋转活动恢复良好。除1例Regan-Morrey Ⅲ型尺骨冠状突骨折患者在术后8~12周时肘关节屈伸活动受限,其他患者肘关节屈伸活动均接近正常。术后均未出现感染、内固定松动或断裂、骨不连、肘关节强直和再脱位等并发症。末次随访时按Mayo评分标准评定肘关节功能:优6例,良8例,可2例,差1例。结论对于合并尺骨冠状突骨折的复杂肘关节骨折脱位,尺骨冠状突骨折复位固定是手术的关键,对术后维持肘关节稳定有着重要意义,进而保证肘关节功能恢复良好。
Objective To explore the significance of reduction and fixation of the ulna coronoid process fractures for the stability of elbow joint after the operation of fracture dislocation of elbow joint. Methods A retrospective analysis of the treatment of 17 cases of complex elbow fracture dislocation with open reduction and internal fixation from March 2008 to July 2013 was performed. The ulna coronoid process fractures were reduced and fixed during the operation. The elbow function was assessed by Mayo elbow score at the last follow-up. Results The patients were follow up between 18 months and 5 years, 38 months on average. All incisions healed by first intention after operation. All patients obtained clinical fracture healing after 12-24 weeks. The forearm rotation of all patients recovered well. The elbow flexion and extension activities in one patient with type Ⅲ ulna coronoid process fracture were restricted for 8-12 weeks, while other patients were nearly normal. All patients had no infection, nonunion, loosening or fracture and dislocation of the elbow stiffness and other complications. The elbow function was assessed by Mayo elbow score at the last follow-up： excellent in 6 cases, good 8 cases, fair 2 cases and poor 1 case. Conclusion For the ulna coronoid process fractures combined with complex elbow fracture dislocation, reduction and fixation of coronoid is the key of the operation, with a great significance in maintaining the stability of elbow joint after operation and ensuring a good recovery of elbow function.
出处
《中国骨与关节损伤杂志》
2017年第5期487-489,共3页
Chinese Journal of Bone and Joint Injury
基金
中央支持地方高校发展专项资金(J13167)
关键词
复杂肘关节骨折脱位
尺骨冠状突骨折
切开复位
内固定
Complex elbow fracture dislocation
Ulna coronoid process fractures
Open reduction
Internal fixation
