尺骨近端粉碎性骨折治疗策略与疗效分析

Treatment Strategy and Effect Analysis of Proximal Ulna Comminuted Fracture

目的分析尺骨近端粉碎性骨折的治疗策略,并探讨单纯肘关节后侧入路运用解剖型锁定钛板螺钉内固定的疗效。方法回顾性分析2011-01/2013-12月作者医院运用尺骨近端锁定钛板及螺钉内固定治疗尺骨近端粉碎性骨折22例患者的临床资料,男14例,女8例;按Colton分型,ⅡC型19例,ⅡD型3例;其中伴有冠状突骨折12例,桡骨小头骨折4例,同时伴有尺骨冠突及桡骨小头骨折4例,合并肘关节前脱位2例。术后1月、2月、3个月、6个月、12个月定期复查X线片,术后1年采用Broberg＆Morrey肘关节功能评分系统评估手术疗效。结果 22例患者获12~24月随访（平均16月）,骨折愈合时间为10~16周（平均13周）,采用Broberg＆Morrey肘关节评分：优12例,良7例,可3例,优良率86.4%。无1例术后皮肤软组织感染或坏死、肘关节僵硬、明显疼痛等并发症。结论单纯肘关节后侧入路运用尺骨近端解剖型锁定钛板及螺钉内固定是治疗尺骨近端粉碎性骨折有效方法之一。

Objective To evaluate the effect of anatomical titanium locking plate in the treatment of proximal corn- minuted tilna fractures.Methods Clinical data of 22 cases treated by anatomical locking titanium plate from January 2011 to December 2013 were reviewed, including 14 male cases and 6 female cases. According to Colton classification, 19 were type Ⅱ C,3 were type ⅡD, 12 cases were accompanied with coronoid process fractures,4 with radial head fractures,4 with both coronoid process fractures and the radial head fractures and 2 with anterior dislocation of the elbow joint. Results The follow-up period of the 22 cases ranged from 12 to 24 months （average 16 months）.All 22 cases showed clinical heal- ing in 10 to 16 weeks （average 13 weeks） . According to Broberg＆Morrey evaluation criteria of the elbow, the treatment results were excellent in 12 cases, good in 7,and fair in 3.The overall satisfactory rate （excellent and good） were 86.4%. No complications such as infection and necrosis, elbow stiffness, obvious pain occurred during the follow-up period. Conclusion It is an effective method to treat comminuted proximal ulna fracture with anatomical locking titanium plate through posterior approach.