使用钢丝内固定治疗尺骨冠突骨折合并肘关节脱位的疗效研究

Study on the effect of wire internal fixation in the treatment of ulna coronal process fracture combined with elbow dislocation

目的:评估使用钢丝内固定治疗尺骨冠突骨折合并肘关节脱位的临床疗效。方法:将2016年8月至2022年1月在清远市人民医院使用钢丝内固定治疗尺骨冠突骨折合并肘关节脱位的21例患者纳入研究。对这些患者均进行≥3个月的随访。根据Regan-Morrey分型标准,13例患者为Ⅱ型,8例患者为Ⅲ型。对于临床疗效的评估使用Mayo肘关节功能评分标准。根据骨折愈合时间、是否发生钢丝断裂、术后骨折端是否移位等指标评价影像学效果。结果:在最终的随访结果中,所有患者均达骨性愈合,平均时间为(4.10±0.95)个月(3.0~5.8个月),无患者发生内固定物断裂或骨折移位。Mayo肘关节功能评分的平均得分为(93.10±7.82)分(80~100分)。骨折愈合后所有内固定材料均被取出。9名患者出现异位骨化,但不影响肘关节的活动范围。结论:使用钢丝内固定治疗尺骨冠突骨折合并肘关节脱位有着良好的临床及影像学疗效。

Objective:To evaluate the clinical efficacy of wire fixation in the treatment of ulna coronoid process fracture combined with elbow dislocation.Methods:From August 2016 to January 2022,a total of 21 patients with ulnar coronal process fracture combined with elbow dislocation were treated with wire internal fixation in Qingyuan People’s Hospital.All patients were followed up for≥3 months.According to the Regan-Morrey classification criteria,13 patients had type II and 8 patients had type III.The clinical efficacy was evaluated using the Mayo elbow function scale.The imaging effects were evaluated according to the healing time of the fracture,whether the wire fracture occurred,and whether the fracture end was displaced after operation.Results:In the final follow-up results,all patients achieved bone union with a mean time of(4.10±0.95)months(3.0 to 5.8 months),and no patients experienced internal fixation rupture or fracture displacement.The average Mayo elbow Function score was(93.10±7.82)(80 to 100).All internal fixation materials were removed after fracture healing.Ectopic ossification occurred in nine patients but did not affect elbow range of motion.Conclusion:The use of wire fixation in the treatment of ulna coronal process fracture combined with elbow dislocation has a good clinical and imaging effect.