Doornberg Job N, de Jong Inge M, Lindenhovius Anneluuk L C, Ring David
Harvard Medical School, Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Boston 02114, USA.
J Shoulder Elbow Surg. 2007 Sep-Oct;16(5):667-70. doi: 10.1016/j.jse.2007.03.013. Epub 2007 May 18.
Fracture of the anteromedial facet of the coronoid process has been recognized as an important type of coronoid fracture. We performed a quantitative analysis of 21 3-dimensional computed tomography scans to evaluate the degree to which the anteromedial facet protrudes as a distinct process separate from the proximal ulnar metaphysis. The distance between the center axis of the trochlear notch and the most medial edge of the anteromedial facet averaged 12.5 mm (range, 8.7-20.1 mm). The part of the maximum anteromedial facet width that was supported by the proximal ulnar metaphysis and diaphysis averaged 5.4 mm (range, 1.7-11.5 mm). On average, 58% of the anteromedial facet (range, 26%-82%) was unsupported by the proximal ulnar metaphysis and diaphysis. It is not surprising that this relatively vulnerable protrusion from the anteromedial facet of the coronoid is frequently a separate fracture fragment in complex traumatic elbow instability.
冠突前内侧小关节面骨折已被确认为冠突骨折的一种重要类型。我们对21例三维计算机断层扫描进行了定量分析,以评估前内侧小关节面作为一个与尺骨近端干骺端分离的独特结构突出的程度。滑车切迹中心轴与前内侧小关节面最内侧边缘之间的距离平均为12.5毫米(范围为8.7 - 20.1毫米)。由尺骨近端干骺端和骨干支撑的前内侧小关节面最大宽度部分平均为5.4毫米(范围为1.7 - 11.5毫米)。平均而言,前内侧小关节面的58%(范围为26% - 82%)未得到尺骨近端干骺端和骨干的支撑。在复杂创伤性肘关节不稳中,冠突前内侧小关节面这种相对脆弱的突出部分经常成为一个单独的骨折碎片,这并不奇怪。