J Am Acad Orthop Surg. 2013 Mar;21(3):149-60. doi: 10.5435/JAAOS-21-03-149.
Proximal ulna fractures can be difficult to manage because of the elbow's complex anatomy. Advances in understanding elbow anatomy and biomechanics, however, have led to new insights. Careful preoperative evaluation is critical because failure to restore normal anatomy of the proximal ulna could have a detrimental effect on postoperative elbow function. Management options include anatomic plates, intramedullary devices, and strong tension band materials. Determining the most appropriate option for an individual fracture is based on analysis of radiographs and CT scans, including three-dimensional reconstruction. Coronoid fractures, olecranon fractures, and associated elbow instability influence the indications for any given fixation device. Appreciating the subtleties of proximal ulna anatomy and biomechanics can lead to improved clinical outcomes. Recent concepts affecting fracture management include proximal ulna dorsal angulation, the importance of the anteromedial facet of the coronoid, and intermediate fragments of the olecranon.
尺骨近端骨折由于肘部复杂的解剖结构而难以处理。然而，对肘部解剖学和生物力学的深入理解导致了新的认识。术前仔细评估至关重要，因为未能恢复尺骨近端的正常解剖结构可能对术后肘部功能产生不利影响。治疗选择包括解剖板、髓内装置和强力张力带材料。确定个体骨折最合适的治疗方案是基于对 X 线和 CT 扫描的分析，包括三维重建。冠状突骨折、鹰嘴骨折和相关的肘关节不稳定影响任何特定固定装置的适应证。了解尺骨近端解剖学和生物力学的细微差别可以带来更好的临床结果。影响骨折管理的最新概念包括尺骨近端背侧成角、冠状突前内关节面的重要性以及鹰嘴的中间骨折块。
