冠突骨折肘关节内翻后内侧旋转不稳定的进展

Advance in coronoid fracture and elbow varus posteromedial rotatory instability

肘关节内翻后内侧旋转不稳定(varus posteromedial rotatory instability,PMRI)系复杂的肘关节不稳定疾病之一。由于其特殊的损伤机制及影像学表现,在临床中较少见且易出现漏诊和误诊。保守治疗易出现较多的并发症,所以手术干预成为了一种有效的治疗方法。但目前对冠突骨折内固定方式和手术入路等都尚无定论。因此,探讨冠突骨折伴PMRI的治疗方式、手术入路以及内固定方法等具有重要意义。通过回顾近年来前内侧面冠突骨折研究及治疗的相关文献,从解剖、生物力学、临床诊断及治疗等方面进行阐述,为今后在临床中治疗PMRI提供相应的参考依据。

Varus posteromedial rotatory instability(PMRI)of the elbow is one of the complex elbow instabilities.This condition is rare in clinic and easy to be missed diagnoses and misdiagnoses due to the specific injury mechanisms and radiological findings.Surgical treatments are effective intervention because the conservative treatment is prone to be more complications.However,there is no definite conclusion on the methods of internal fixation and surgical approaches for the treatment of the coronoid fractures.Therefore,it is important to investigate the methods of treatment,surgical approaches and internal fixation of coronoid fractures in PMRI.In the present review,the anatomy,biomechanics and clinical diagnosis and treatment of the coronoid anteromedial facet fractures were analyzed and summarized,in order to provide a better reference for PMRI in clinical treatment.