Wang P, Zhuang Y, Li Z, Wei W, Fu Y, Wei X, Zhang K
Department of orthopedics and trauma, Xi'an Hong Hui Hospital, Xi'an Jiaotong University Health Science Center, No. 555, East Friendship Road, Xi'an City 710054, Shaanxi Province, China.
Department of orthopedics and trauma, Xi'an Hong Hui Hospital, Xi'an Jiaotong University Health Science Center, No. 555, East Friendship Road, Xi'an City 710054, Shaanxi Province, China.
Orthop Traumatol Surg Res. 2017 May;103(3):447-451. doi: 10.1016/j.otsr.2016.12.017. Epub 2017 Feb 7.
Coronoid fractures are notoriously difficult to manage particularly when there is a small fragment. We report a retrospective analysis of our experience with consecutive type I and II Regan-Morrey coronoid fractures using a lasso plate.
Type I and II Regan-Morrey coronoid fractures can be effectively managed using a lasso plate.
From October 2011 and December 2013, 25 patients (21 males and 4 females, mean age 40.0 years) with type I and II Regan-Morrey coronoid fractures were treated with the open reduction and internal fixation (ORIF) using the lasso plate. Postoperative measurements of the elbow range of motion were recorded. Elbow function was evaluated by the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) score.
All patients were reexamined at a mean follow-up of 32.7 months (range: 24-49 months). The mean fractures healing time was 13.6 weeks (range: 6 to 18 weeks). The mean flexion range of the elbow was 121.8° (range: 90° to 135°) and the mean extension range of the elbow was 10.6° (range: 0° to 20°). The mean pronation of the forearm was 75.8° (range: 65° to 85°). The mean supination of the forearm was 80.4° (range: 70° to 90°). The mean DASH score was 10.2 (range: 0 to 28). The mean MEPS was 83.4 (range: 55 to 95), 8 patients (32%) were rated excellent, 14 patients (56%) were rated good, 2 (8%) patients were rated fair. One (4%) patient was rated poor. No patient was seriously infected but implant breakage was found in one case. Two cases of elbow heterotopic ossification (HO) were observed. Two cases of elbow medial instability were observed.
The type I and II Regan-Morrey coronoid fractures combined with the instability of the elbow should be operated. The lasso plate reduces the pressure between the wire and the insertion of capsule. A tight wire results in greater stability than ordinary suture fixation, thus enabling early functional exercise.
In the treatment of type I and II Regan-Morrey coronoid fractures, lasso plate can provide concentric fracture reduction of the elbow and stable fixation to allow for early rehabilitation. Good clinical outcomes can be anticipated.
Level IV: retrospective study.
冠突骨折 notoriously difficult to manage ，尤其是存在小骨折块时。我们报告了一项回顾性分析，总结了我们使用套索钢板连续治疗I型和II型Regan-Morrey冠突骨折的经验。
使用套索钢板可有效治疗I型和II型Regan-Morrey冠突骨折。
2011年10月至2013年12月，25例（21例男性，4例女性，平均年龄40.0岁）I型和II型Regan-Morrey冠突骨折患者采用套索钢板切开复位内固定（ORIF）治疗。记录术后肘关节活动范围的测量值。通过Mayo肘关节功能评分（MEPS）和上肢、肩部和手部功能障碍（DASH）评分评估肘关节功能。
所有患者平均随访32.7个月（范围：24 - 49个月）后复查。平均骨折愈合时间为13.6周（范围：6至18周）。肘关节平均屈曲范围为121.8°（范围：90°至135°），平均伸展范围为10.6°（范围：0°至20°）。前臂平均旋前为75.8°（范围：65°至85°）。前臂平均旋后为80.4°（范围：70°至90°）。平均DASH评分为10.2（范围：0至28）。平均MEPS为83.4（范围：55至95），8例（32%）评为优秀，14例（56%）评为良好，2例（8%）评为中等。1例（4%）评为差。无患者发生严重感染，但1例出现植入物断裂。观察到2例肘关节异位骨化（HO）。观察到2例肘关节内侧不稳定。
I型和II型Regan-Morrey冠突骨折合并肘关节不稳定时应进行手术治疗。套索钢板降低了钢丝与关节囊附着处之间的压力。紧密的钢丝比普通缝线固定具有更大的稳定性，从而能够早期进行功能锻炼。
在治疗I型和II型Regan-Morrey冠突骨折时，套索钢板可使肘关节骨折实现同心复位并提供稳定固定，以允许早期康复。可预期获得良好的临床结果。
IV级：回顾性研究。
