Doornberg Job N, van Duijn Joppe, Ring David
Orthopaedic Hand and Upper Extremity Service, Harvard Medical School, Boston, MA, USA.
J Hand Surg Am. 2006 May-Jun;31(5):794-7. doi: 10.1016/j.jhsa.2006.01.004.
The coronoid fractures that occur in the terrible-triad pattern of traumatic elbow instability (posterior dislocation with fractures of the radial head and coronoid) usually are small transverse fragments. Attempts to classify these fragments according to height as suggested by Regan and Morrey have been inconsistent and contentious. The purpose of this study was to quantify coronoid fracture height in terrible-triad injuries.
The height of the coronoid process of the ulna and the coronoid fracture fragment were measured on computed tomography scans of 13 patients with terrible-triad-pattern elbow injuries. Two observers performed the measurements with excellent intraobserver and interobserver reliability.
The total height of the coronoid process of the ulna averaged 19 mm. The average height of the coronoid fracture fragment was 7 mm. This corresponds to an average of 35% of the total height of the coronoid process.
The transverse coronoid fractures associated with terrible-triad elbow injuries have a variable height that may not be easy to classify according to the system of Regan and Morrey. Classification of coronoid fractures according to fracture morphology and injury pattern may be preferable.
创伤性肘关节不稳定的“恐怖三联征”（桡骨头骨折合并冠状突骨折及肘关节后脱位）中出现的冠状突骨折通常为小的横行骨折块。按照Regan和Morrey所建议的根据骨折块高度进行分类的尝试一直存在不一致性且颇具争议。本研究的目的是量化“恐怖三联征”损伤中冠状突骨折的高度。
在13例“恐怖三联征”型肘关节损伤患者的计算机断层扫描图像上测量尺骨冠状突及冠状突骨折块的高度。两名观察者进行测量，观察者内及观察者间的可靠性均极佳。
尺骨冠状突的总高度平均为19mm。冠状突骨折块的平均高度为7mm。这相当于冠状突总高度的平均35%。
与“恐怖三联征”型肘关节损伤相关的横行冠状突骨折高度各异，可能难以按照Regan和Morrey的系统进行分类。根据骨折形态和损伤模式对冠状突骨折进行分类可能更为可取。
