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关节镜辅助下冠状突骨折的治疗

Arthroscopic-assisted treatment of coronoid fractures.

作者信息

Adams Julie E, Merten Sheri M, Steinmann Scott P

机构信息

Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota 55905, USA.

出版信息

Arthroscopy. 2007 Oct;23(10):1060-5. doi: 10.1016/j.arthro.2007.05.017.

Abstract

PURPOSE

Little information exists regarding arthroscopic treatment of coronoid fractures; this study reports outcomes in a series of patients.

METHODS

Forty-one coronoid fractures were identified by retrospective chart review; 7 were treated arthroscopically; 6 with >12 months of available follow-up. Regan-Morrey fracture types were II (n = 4) and III (n = 3). The age of the patients averaged 37 years; the mechanism of injury was a fall in 6 patients and a motocross accident in 1 patient. Fracture fixation included: plate-and-screws following arthroscopic reduction (1); screws (2) and threaded Steinmann pins (2); 2 fractures were debrided. Three patients had immediate (2) or delayed (1) lateral ulnar collateral ligament repair.

RESULTS

Follow-up averaged 31.8 months. The range of motion averaged 9 degrees to 133 degrees in flexion-extension and 87 degrees/79 degrees in prono-supination. Mayo Elbow Performance scores were 100 in 5 of 6 patients and unavailable in 1 patient. Complications included asymptomatic heterotopic ossification (1) and delayed ulnar neuropathy (1).

CONCLUSIONS

In our series of coronoid fractures treated with arthroscopic means, all patients had a functional, pain-free result. All patients returned to preoperative avocations and occupations.

LEVEL OF EVIDENCE

Level IV, therapeutic case series.

摘要

目的

关于冠状突骨折的关节镜治疗的信息较少;本研究报告了一系列患者的治疗结果。

方法

通过回顾性病历审查确定了41例冠状突骨折;7例接受了关节镜治疗;6例有超过12个月的可用随访资料。Regan-Morrey骨折类型为Ⅱ型(n = 4)和Ⅲ型(n = 3)。患者平均年龄37岁;损伤机制为6例患者跌倒,1例患者发生摩托车越野事故。骨折固定方式包括:关节镜下复位后钢板螺钉固定(1例);螺钉固定(2例)和螺纹斯氏针固定(2例);2例骨折进行了清创。3例患者进行了即时(2例)或延迟(1例)尺侧副韧带修复。

结果

随访平均31.8个月。屈伸活动范围平均为9度至133度,旋前-旋后活动范围为87度/79度。6例患者中有5例Mayo肘关节功能评分100分,1例患者未进行评分。并发症包括无症状性异位骨化(1例)和迟发性尺神经病变(1例)。

结论

在我们这组采用关节镜治疗的冠状突骨折患者中,所有患者均获得了功能良好、无痛的结果。所有患者均恢复了术前的业余爱好和工作。

证据水平

IV级,治疗性病例系列。

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