Yang Xiaohua, Chen Wei, Li Guoping, Wang Jianji, Zhao Haitao, Shi Litao, Cao Xiangyu, Zhang Yingze
The Second Department of Orthopaedics, the Affiliated Hospital of Chengde Medical College, Chengde Hebei, 067000, P. R. China.
Emergency Center of Trauma, the Third Hospital of Hebei Medical University.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2016 May 8;30(5):537-540. doi: 10.7507/1002-1892.20160108.
To investigate the advantages and effectiveness of anterior neurovascular interval approach for fixation of ulna coronoid process fracture.
Between February 2011 and April 2015, 8 patients with ulna coronoid process fracture were treated with open reduction and internal fixation by anterior neurovascular interval approach. There were 5 males and 3 females, aged from 14 to 62 years (mean, 34 years). Fractures were caused by falling in 5 cases, traffic accident in 2 cases, and crashing in 1 case. The time between injury and operation was 1-6 days (mean, 3.5 days). According to Adams classification, there were 4 cases of type II, 1 case of type III, 2 cases of type IV, and 1 case of type V. In 1 patient with joint instability, lateral collateral ligament repair was given through another incision after fixation of coroniod fracture and the hinged external fixator, and plast splin was used to fix in the other patients; function exercise was done after removal of external fixtion.
All incisions healed by first intention, and no complications of neurovascular injury and deep infection occurred. All patients were followed up 6-48 months (mean, 22 months). The healing time of fracture was 8-15 weeks (mean, 12.6 weeks). Mild myositis ossificans occurred in 1 case. The flexionextension arc of the elbow was (125.00±7.07)° and the forearm rotation was (135.00±7.07)°, showing no significant difference when compared with those of normal side[(126.88±7.53)° and (139.38±8.21)°] (=0.469, =0.654; =2.198, =0.054). According to Morrey's scale, the results were excellent in 6 cases, good in 2 cases; the excellent and good rate was 100%.
Anterior neurovascular interval approach for reduction and internal fixation of ulna coroniod fractures has the advantages of simple operation, less trauma, and larger operative field. It can be used alone or combined with other surgical approaches.
探讨经前神经血管间隙入路治疗尺骨冠状突骨折的优势及疗效。
2011年2月至2015年4月，采用经前神经血管间隙入路切开复位内固定治疗8例尺骨冠状突骨折患者。其中男5例，女3例，年龄14～62岁，平均34岁。致伤原因：坠落伤5例，交通事故伤2例，撞击伤1例。受伤至手术时间1～6天，平均3.5天。按Adams分型：Ⅱ型4例，Ⅲ型1例，Ⅳ型2例，Ⅴ型1例。1例合并关节不稳患者在冠状突骨折固定后经另一切口行外侧副韧带修复并应用铰链式外固定器，其余患者采用石膏托固定；外固定去除后进行功能锻炼。
所有切口均一期愈合，未发生神经血管损伤及深部感染等并发症。所有患者均获随访，随访时间6～48个月，平均22个月。骨折愈合时间8～15周，平均12.6周。1例发生轻度骨化性肌炎。患侧肘关节屈伸活动度为（125.00±7.07）°，前臂旋转活动度为（135.00±7.07）°，与健侧比较差异无统计学意义[（126.88±7.53）°和（139.38±8.21）°，=0.469，=0.654；=2.198，=0.054]。按Morrey评分标准：优6例，良2例；优良率为100%。
经前神经血管间隙入路治疗尺骨冠状突骨折具有操作简单、创伤小、术野显露充分等优点，可单独应用或联合其他手术入路使用。
