前内侧入路空心钉固定治疗尺骨冠状突骨折的疗效分析

目的探讨前内侧入路采用空心钉固定技术治疗尺骨冠状突骨折的临床疗效。方法回顾性分析2017年1月至2020年1月经肘关节前内侧小切口入路采用空心钉固定技术微创治疗尺骨冠状突骨折32例患者的临床资料,其中男20例,女2例;年龄19〜57(43.7±9.8)岁。根据Regan-Morrey分型:Ⅱ型21例,Ⅲ型11例;根据O’Driscoll分型:冠状突尖骨折13例,冠状突前内侧面骨折16例,基底部骨折3例。所有患者均采用改良前内侧入路应用微创空心钉固定技术进行治疗。采用Mayo肘关节功能评分(MEPS)和Broberg&Morrey评分评价肘关节的功能。结果本研究患者均获得随访,平均14.1个月。X线示骨折均获得临床愈合,愈合时间平均10.6周。无重大神经损伤及骨折再移位发生。随访时肘关节平均屈曲115。,平均伸直丢失12。,平均旋前70,平均旋后65。。MEPS评分:优18例,良10例,一般3例,差1例。Broberg&Morrey评分:优19例,良10例,一般2例,差1例。结论前内侧入路空心钉固定技术治疗尺骨冠状突骨折,具有暴露清晰、直视复位、并发症少等优点,术后肘关节功能恢复良好。

Objective To investigate the clinical effect of anteromedial approach with hollow nail fixation for ulnar coronoid process fracture.Method From January 2017 to January 2020,32 patients with ulnar coronoid process fracture were treated with minimaUy invasive cannulated nail fixation through anteromedial elbow small incision approach in the Department of Orthopedics of our hospital,including 20 males and 12 females.The patients were 19~57 years old(43.7±9.8 years old).According to Regan-Morrey classification:Ⅱ type 21 cases,Ⅲ type 11 cases;according to O'Driscoll classification,there were 13 cases of apical fracture,16 cases of anterior medial fracture,and 3 cases of basal fracture.All patients were treated with a modified anteromedial approach using a minimally invasive hollow nail fixation technique.Mayo elbow function score(MEPS)and Broberg&Morrey score were used to evaluate elbow function.Results All patients in this study were foUowed up for an average of 14.1 months.X-rays showed that all fractures healed clinically,with a mean healing time of 10.6 weeks(8〜14 weeks).No major nerve injury and fracture redisplacement occurred.At the final follow-up,the elbow had a mean flexion of 115°,a mean loss of extension of 12°,a mean pronation of 70°,and a mean supination of 65°.MEPS score:excellent in 18 cases,good in 10 cases,average in 3 cases,poor in 1 case.Broberg&Morrey score:excellent 19 cases,good 10 cases,average 2 cases,poor 1 case.Conclusion Anteromedial approach with cannulated nail fixation in the treatment of ulnar coronoid process fracture has the advantages of clear exposure,direct reduction and less complications,and the function of the elbow joint recovered well after operation.