微型钢板治疗尺骨冠状突骨折

TREATMENT OF ULNAR CORONOID PROCESS FRACTURE WITH MINI-PLATE

目的探讨应用微型钢板治疗尺骨冠状突骨折的内固定方法并评估其疗效。方法 2006年9月-2009年3月,对14例尺骨冠状突骨折行开放复位、微型钢板内固定治疗。男10例,女4例;年龄14～51岁,平均29岁。摔伤4例,车祸伤10例。左侧6例,右侧8例。骨折按Regan-Morrey分型:Ⅰ型2例,Ⅱ型6例,Ⅲ型6例。肘关节屈伸活动度为(60±10)°,前臂旋转活动度为(70±10)°。伤后30min～11d入院,经CT三维成像检查后确诊。术后1周在医生指导下行早期功能锻炼。结果术后切口均Ⅰ期愈合。X线片示骨折均临床愈合,愈合时间7～12周,平均10周。14例均获随访,随访时间12～25个月,平均17个月。无神经损伤及骨折再移位发生。2例发生异位骨化。肘关节屈伸活动度为(110±10)°,前臂旋转活动度为(130±15)°;与术前比较,差异均有统计学意义(P<0.05)。疗效根据Morrey等的肘关节功能诊断标准评定,优8例,良4例,中2例,优良率85.7%。结论微型钢板治疗尺骨冠状突骨折固定可靠,术后可早期行肘关节功能锻炼。

Objective To investigate the treatment of ulnar coronoid process fracture with mini-plate and to evaluate the clinical results. Methods Between September 2006 and March 2009, 14 patients with ulnar coronoid process fracture were treated with open reduction and internal fixation of mini-plate. There were 10 males and 4 females with an average age of 29 years （range, 14-51 years）. Fracture was caused by falling from height in 4 cases and traffic accident in 10 cases. The locations were left side in 6 cases and right side in 8 cases. According to Regan-Morrey classification, there were 2 cases of type Ⅰ, 6 of type Ⅱ, and 6 of type Ⅲ. The flexion-extension arc of the elbow was （60 ± 10）° and the forearm rotation was （70 ± 10）°. The disease duration was 30 minutes to 11 days, and CT scan was used for definite diagnosis. Patients received early functional exercise 1 week postoperatively. Results All incisions healed by first intention. Fourteen cases were followed up 12-25 months （17 months on average）. All fractures healed well, and the average union time was 10 weeks with a range of 7-12 weeks. No 1oosening or breakage of the internal fixation occurred except for 2 patients who had heterotopic ossification. The flexion-extension arc of the elbow was （110 ± 10）° and the forearm rotation was （130 ± 15）°, showing significant difference when compared with that before operation （P〈0.05）. The clinical results were evaluated according to Morrey’s scale, 8 cases were rated as excellent, 4 as good, and 2 as fair; the excellent and good rate was 85.7%. Conclusion Fixation of ulnar coronoid process fracture with mini-plate provides sufficient stability to do early functional exercise and it can enhance functional outcome.