肘关节前侧入路微型钢板内固定治疗尺骨冠状突骨折的临床疗效

Clinical Effect of Anterior Approach of the Elbow Joint with Mini-Plate Internal Fixation for the Treatment of Ulnar Coronoid Process Fracture

目的评估肘关节前侧入路微型钢板内固定治疗尺骨冠状突骨折的临床疗效。方法选取2014年5月~2017年7月我科收治的尺骨冠状突骨折患者12例,采用肘关节前侧入路微型钢板内固定治疗。术后第2天开始肘关节屈伸功能锻炼,术后1、2、3、6、12、24个月定期复查X线了解骨折愈合情况进行随访,观察手术时间、术中出血量、伤口愈合、骨折愈合及术后并发症情况,测量肘关节屈伸活动度及旋转活动度,术后1年对肘关节功能进行评价。结果患者均获随访12~24个月,平均(15.73±1.83)个月。手术时间(63.54±8.73)min,术中平均出血量(30.24±6.38)ml。12例患者切口均Ⅰ期愈合,骨折均获得临床愈合。2例早期患者术后出现示指、中指掌侧麻木,伴有肘部TILE征阳性,术后1周明显好转,术后3个月随访时感觉完全恢复。末次随访时,患侧肘关节屈伸活动(118.42±12.26)°,旋转(132.37±17.18)°。术后1年肘关节功能优良率为91.67%。结论采用肘关节前侧入路微型钢板内固定治疗尺骨冠状突骨折,手术创伤小,术后恢复快,可早期功能锻炼,具有良好的临床效果。

Objective To evaluate the clinical efficacy of the anterior approach of the elbow joint for the treatment of ulnar coronoid process fractures. Methods 12 patients with ulnar coronoid process fractures admitted to our department from May 2014 to July 2017 were treated with mini-plate internal fixation with anterior elbow approach. On the second day after operation, the elbow flexion and extension function was started. After 1, 2, 3, 6, 12, and 24 months, the X-ray was reviewed regularly to understand the fracture healing. The operation time, intraoperative blood loss, wound healing, and observation were observed. Fracture healing and postoperative complications were measured. The flexion and extension of the elbow joint and the degree of rotational activity were measured. The elbow joint function was evaluated 1 year after operation. Results All patients were followed up for 12 to 24 months, with an average of (15.73±1.83) months. The operation time was (63.54±8.73) min, and the average intraoperative blood loss was (30.24±6.38) ml. All 12 patients underwent incision in the first stage, and the fractures were clinically healed. 2 patients with early stage showed numbness of the index finger and middle finger volar, accompanied by positive TILE of the elbow, which was significantly improved 1 week after operation, and felt completely recovered after 3 months of follow-up. At the last follow-up, the flexion and extension of the affected elbow joint (118.42±12.26)°, rotation (132.37±17.18)°. The excellent and good rate of elbow joint function was 91.67% after 1 year.Conclusion The anterior approach of the elbow joint for the treatment of ulnar coronoid process fractures with small trauma, quick recovery after operation, early functional exercise and good clinical results.