Shen Longxiang, Yu Xingang, Zhong Biao, Ding Jian
Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, PR China.
Department of Orthopedic Surgery, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai 200233, PR China.
Int J Surg Case Rep. 2017;33:130-134. doi: 10.1016/j.ijscr.2017.02.016. Epub 2017 Feb 21.
Sufficient fixation of an anterior or anteromedial facet fracture of the coronoid process in fracture-dislocation of elbow is important to maintain joint stability. The purpose of this study was to report our experience with 11 patients who were managed with an original fixation technique using a "figure-eight" suture loop.
From February 2010 to March 2011, 11 cases with a fracture of the anterior or anteromedial facet of the coronoid process were treated by coronoid fixation using a figure-eight suture loop. For cases with comminuted fractures, to prevent a suture from sliding into the fracture line, a 3- or 4-hole phalanx plate was enclosed in the suture loop to compress multiple fragments. Accompanying injuries, such as a radial head fracture or olecranon fracture, were fixed with repair of lateral collateral ligament injuries.
On final evaluations at an average of 18 months after injury, the mean elbow arc of motion was 125.5° and the mean forearm rotation arc of 124.1°. All fractures were united with an average postoperative score according to the Mayo Elbow Performance Index of 91 points. All patients achieved satisfactory scores (seven excellent, four good). All 11 fractures were united at final follow-up with no joint incongruity, dislocation, or subluxation of the injured elbow.
The figure-eight suture loop technique is an easy and effective technique to fix anterior or anteromedial facet fractures of the coronoid process.
在肘关节骨折脱位中，充分固定冠状突前侧或前内侧小关节面骨折对于维持关节稳定性至关重要。本研究的目的是报告我们对11例采用“8”字缝线环原始固定技术治疗患者的经验。
2010年2月至2011年3月，对11例冠状突前侧或前内侧小关节面骨折患者采用“8”字缝线环进行冠状突固定治疗。对于粉碎性骨折病例，为防止缝线滑入骨折线，在缝线环内包绕一块3孔或4孔指骨钢板以挤压多个骨折块。对于合并的损伤，如桡骨头骨折或鹰嘴骨折，在修复外侧副韧带损伤的同时进行固定。
在平均伤后18个月的最终评估中，平均肘关节活动弧为125.5°，平均前臂旋转弧为124.1°。所有骨折均愈合，根据Mayo肘关节功能指数，术后平均评分为91分。所有患者评分均满意（7例优，4例良）。在末次随访时，所有11例骨折均愈合，受伤肘关节无关节不匹配、脱位或半脱位。
“8”字缝线环技术是一种固定冠状突前侧或前内侧小关节面骨折的简便有效技术。
