Department of Orthopedics, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, PR China; Laboratory of Stem Cell and Tissue Engineering, West China Hospital, Sichuan University, Chengdu 610041, PR China.
Department of Orthopedics, Yaan People's Hospital, Yaan, Sichuan 625000, PR China.
Int J Surg. 2018 Jun;54(Pt A):37-47. doi: 10.1016/j.ijsu.2018.04.028. Epub 2018 Apr 22.
Capitellum and trochlea fractures are truly rare and the treatment is not fully appreciated. So we evaluate the impact of associated injuries and fracture classifications on elbow functional outcomes after open reduction and internal fixation.
PubMed, Embase, Ovid Medline, and the Cochrane Library were searched from January 1, 1974 to January 1, 2017. All English literature with the treatment of capitellum and trochlea fractures by open reduction and internal fixation were included.
For associated injuries, the results suggested that the MEPI score of patients without associated injuries was higher than that of patients with associated injuries (P = 0.001). However, there was no significant difference in the arc of motion between the two groups (P = 0.052). For Bryan and Morrey classification, there was no significant difference in the MEPI score (P = 0.622) and in the arc of motion (P = 0.652) between type-I fractures and type-IV fractures. For Dubberley classification, there was significant difference only in the MEPI score between subtype-A fractures and subtype-B fractures (P = 0.005).
The associated injury of fracture may have a negative impact on the functional outcomes of elbow. And Dubberley classification is more suitable to classify this kind of fracture. Furthermore, high-quality studies are required to attain robust evidence.
头状骨和滑车骨折十分罕见，其治疗方法尚未完全明确。因此，我们评估了开放性复位内固定术后合并损伤和骨折分型对肘关节功能的影响。
检索了 1974 年 1 月 1 日至 2017 年 1 月 1 日期间的 PubMed、Embase、Ovid Medline 和 Cochrane 图书馆，纳入所有采用开放性复位内固定治疗头状骨和滑车骨折的英文文献。
对于合并损伤，结果显示无合并损伤患者的 MEPI 评分高于合并损伤患者（P=0.001）。但两组的活动度无显著差异（P=0.052）。对于 Bryan 和 Morrey 分型，Ⅰ型和Ⅳ型骨折的 MEPI 评分（P=0.622）和活动度（P=0.652）无显著差异。对于 Dubberley 分型，仅在 A 亚型和 B 亚型骨折的 MEPI 评分方面有显著差异（P=0.005）。
骨折的合并损伤可能对肘关节的功能结果产生负面影响。Dubberley 分型更适合对这类骨折进行分型。此外，需要高质量的研究来获得更可靠的证据。
