尺骨冠状突骨折16例疗效分析

Analysis of Operative therapeutic effect in 16 cases of fractures of ulna coronoid process

目的分析尺骨冠状突骨折手术治疗的必要性,评价合并有韧带损伤或桡骨头骨折的修复效果。方法2001-2004年手术治疗16例尺骨冠状突骨折患者,其中男14例,女2例；年龄18～54岁,平均36．6岁。手术中骨折复位后以螺钉或克氏针固定,同时修复前关节囊,对合并桡骨头骨折或侧副韧带损伤给予同期处理,术后功能锻炼。结果随访8～24个月,骨折临床愈合时间6～8周。平均Mayo肘关节评分80分。结论冠状突骨折需积极处理,重视软组织及韧带的检查及处理,尽量保留桡骨小头的完整性。单纯冠状突骨折手术处理后疗效较好。

Objective To analyze the operative effect of fracture of ulna coronoid process and evaluate the repairing effect of reconstruction of combined injury of ligamental structure or radius head. Methods During 2001 to 2004,16 cases （ 14 males and 2 females ） of fractures of ulna coronoid process, aged 18-54 years （mean 36.6 years）, were treated operatively in our department. Routine medial approach on the elbow or anterior trance-joint approach was used. Once reduction was achieved, screws or Kirschner wires were used to fix the fracture and the capsule was repaired at the same time. If there was combined fracture of the radius head or rupture of the collateral ligament ,simultaneous repair or resection was applied. Functional exercise was requested in all patients. Results The follow-up was 8 to 24 months. Fracture union needed 4 to 6 weeks. Average Mayo elbow score was 80. Conclusion Ulna coronoid process fractures need active therapy. The radius head should be reserved as complete as possible during treatment. It is necessary to work out a standard management plan, and a notice should be taken to ligamental structure examination.