尺骨冠状突骨折的诊断与治疗进展

The Research Progress of Diagnosis and Treatment of Ulna Coronoid Process Fractures

尺骨冠状突骨折临床并不少见,但临床治疗较为棘手。对于Regan-Morrey I型和Ⅱ型的骨折来说,其对肘关节稳定性的影响不显著,可采取非手术治疗。但是也有一些Ⅱ型的骨折合并肘关节后方脱位,由于复位后会有脱位复发的潜在风险,故也要求手术处理。尺骨冠状突骨折经常会合并肘关节周围组织结构的损伤,应争取在最短时间行手法复位,石膏托或支具外固定保护。对肿胀严重有发生筋膜室综合征的应早期行切开减张。手术多应用内侧的入路,并存桡侧副韧带损伤的时候需联合外侧的入路。内植物材料包括微型钛板、微型螺钉、可吸收螺钉、空心拉力钉、带线锚钉、外固定支架、冠状突假体置换等。

Ulna coronoid process fractures are are not uncommon in clinic, but the clinical treatment more difficult. Regan-Morrey type Ⅰ,Ⅱ fracture had no significant effect on the stability of the elbow joint, conservative treatment can be used. For some type Ⅱ fractures with elbow dislocation after, due to reset again after dislocation of the potential danger, also require surgical treatment. Ulna coronoid process fractures often comorbid elbow other tissues, should strive for the fastest time line gimmick reset, external fixation with a cast or protection. Swelling of the severe cases with bone fascia room syndrome should be early open reduction surgery. Choice most medial approach, but when the merger of the lateral collateral ligament injury needs a combination of the lateral approach. Internal fixation materials include ： miniature titanium plate, micro screws, absorbable screws, hollow screw, anchor nail and external fixator and coronoid process of prosthetic replacement, etc.