肘前侧入路治疗伴尺骨冠突骨折的肘关节骨折疗效观察

摘要

Objective To investigate the clinical effect of elbow anterior approach for treatment of elbow injury with ulnar cor-onoid process fracture.Methods Twenty-six patients of elbow injures with ulna coronoid process fractures were treated by anterior el-bow approach.We fixed the coronoid fractures with mini plates,screws and anchors.We evaluated the elbow function according to Mayo Elbow Performance Score(MEPS).Results All incisions were healed successfully.The patients were followed up for 12~30 months. The fractures were healed within 9 to 16 weeks with an average of 12.2 weeks.One case suffered from heterotopic ossification after 3 months but no special treatment was given.Another case suffered from stiff elbow after 2 months of operation and was recovered by the treatment of rehabilitation therapy.In the last follow-up,the flexion-extension arc of the elbow was (120 ± 18.4) degree and the fore-arm rotation arc was (128 ± 18.8) degree.According to MEPS,the results were excellent in 16 cases,good in 8 cases and fair in 2 ca-ses.The excellent and good rate was 92.3%.Conclusion Elbow anterior approach for treatment of elbow injury with ulnar coronoid process fracture has the advantages of large operative field and simple operation.It is safe and effective to fix the fracture to restore the stability of the elbow and the recovery of joint function.%目的 利用肘关节前侧入路治疗伴尺骨冠突骨折的肘关节骨折的临床疗效.方法 26例伴尺骨冠突骨折的肘关节骨折患者,采用经肘关节前侧入路手术.手术采用微型钢板、螺钉、锚钉固定尺骨冠突骨折.功能评价采用Mayo肘关节功能评分标准.结果 所有患者切口顺利愈合,随访12~30月.冠突骨折于术后9~16周达临床愈合,平均12.2周.1例于术后3个月出现异位骨化,未予特殊处理;1例于术后2个月肘关节出现僵硬,经康复锻炼后好转.末次随访时,肘关节屈伸活动度为(120±18.4)°,前臂旋转活动度为(128±18.8)°.肘关节功能优16例,良8例,可2例,优良率92.3%.结论 经肘关节前侧入路治疗伴尺骨冠突骨折的肘关节骨折显露清晰,操作方便,可安全有效固定骨折端以恢复肘关节稳定性,促进关节功能康复.