尺骨冠状突骨折的诊断与治疗进展

摘要

[Summary] Ulna coronoid process fractures are not uncommon in clinical practice,but its treatment is difficult.Regan-Morrey type Ⅰ and Ⅱ fracture has no significant effect on the stability of the elbow joint,thus conservative treatment can be used.For some type Ⅱ fractures combined with elbow posterior dislocation,surgical treatment is required because of the potential danger of recurrent dislocation after reduction.Ulna coronoid process fractures often accompany other tissue injury,therefore manipulative reduction and external fixation with a cast or brace should be given as soon as possible.Once severe swelling complicated with bone fascia compartment syndrome,early decompression should be performed.The surgery can be carried out via medial approach,or in combination with lateral approach when lateral collateral ligament injury exists.Internal fixation materials include miniature titanium plate,micro screws,absorbable screws,hollow screw,anchor nail,external fixator and coronoid process of prosthetic replacement.%尺骨冠状突骨折临床并不少见，但治疗较为棘手。Regan-Morrey Ⅰ、Ⅱ型骨折对肘关节的稳定性无显著影响，可采用保守治疗。对部分Ⅱ型骨折伴肘关节后脱位，因复位后有再次脱位的潜在危险，需要行手术治疗。尺骨冠状突骨折常伴发肘关节其他组织的损伤，应争取在第一时间行肘关节脱位手法复位，石膏托或支具外固定保护。肿胀严重发生筋膜室综合征时应早期切开减张。手术多取内侧入路，合并外侧副韧带损伤时联合使用外侧入路；内固定材料有微型钛板、微型螺钉、可吸收螺钉、空心拉力钉、带线锚钉、外固定支架、冠状突假体置换等。