关节镜下复位固定治疗尺骨冠突骨折的短期临床疗效

Short-term Clinical Outcome of Arthroscopic-assisted Management of Ulnar Coronoid Process Fractures

目的：探讨关节镜下复位固定治疗尺骨冠突骨折的可行性。方法：2009年1月至2012年6月,采用全镜下技术,使用克氏针或AO中空螺钉,从后向前固定骨折,治疗尺骨冠状突骨折10例。其中男6例,女4例;年龄16岁-68岁,平均45岁;左侧3例,右侧7例;1例合并同侧肱骨小头骨折,1例合并同侧肘关节外尺侧副韧带损伤,其余8例患者均为单纯尺骨冠状突骨折。按照ReganMorrey分型：Ⅰ型2例,Ⅱ型7例,Ⅲ型1例;按照O’Driscoll分型：Ⅰ型2例,Ⅱ型7例,Ⅲ型1例。结果：关节镜下及术后X线片均提示骨折复位良好,内固定物位置好。本组10例患者均获得随访,随访时间10个月-28个月,平均12.5个月。骨折愈合良好,患者的肘关节平均伸直为0°（过伸15°-5°）,屈曲为135°（130°-145°）;前臂旋转正常,无1例出现肘关节不稳定;1例发生无症状的异位骨化,无1例发生血管神经损伤等并发症。Morrey肘关节功能评分均为优。结论：关节镜下复位固定治疗尺骨冠突骨折能提供良好的视野,能够在保护骨折周围软组织的条件下达到解剖复位及牢固固定,肘关节功能恢复良好。

Objective To investigate the feasibility of arthroscopic reduction and fixation of ulnar coronoid process fracture. Methods 10 patients（6 male and 4 female）with ulnar coronoid process fracture were treated arthroscopically in our hospital and were followed up for an average of 12.5 months.There were 2 cases of type I,7 cases of type II,and 1 case of type III according to the Regan–Morrey Grouping;and 2 cases of type I,7 cases of type II,and 1case of type III according to O＇Driscoll Grouping. Results All patients achieved full pronation and supination with an average elbow extension of0°（hyperextension-15° to 5°）and average elbow flexion of 135°（130° to 145°）. Their Morrey Elbow Performance Scores were above 95. One patient had asymptomatic heterotopic ossification and two had hardware irritation. No elbow instability and neurovascular complications occurred. Conclusions The procedure yielded better vision field for anatomic reduction and achieved firm fixation and full recovery of elbow function.