Shi Y, Wang G-F, Mei K, Zhang J, Yun C-J, Qian C, Sun J-Y
Department of Orthopaedic Surgery, The Affiliated Wujin Hospital of Jiangsu University, Changzhou, China.
Acta Chir Orthop Traumatol Cech. 2018;85(2):102-108.
PURPOSE OF THE STUDY This study aims to analyze the clinical and radiographic outcomes of a consecutive series of 18 patients with terrible triad injury. The coronoid fractures of these patients were repaired using Mother-Child screw (MCS). MATERIAL AND METHODS Twelve men and six women (mean age: 47.2 years) with terrible triad injury of the elbow were followed up for a mean of 17.6 months (range: 13-42 months). Surgical treatment consisted of open reduction and internal fixation of coronoid fractures with MCS, radial head fracture with MCS (Mason type II, n = 10), or mini-plate (Mason type III, n = 3). Furthermore, all underwent lateral collateral ligament repair (n = 9, 100%), and in cases of persistent instability, medial collateral ligament repair was performed (n = 3, 33%). RESULTS At last follow-up, average arc of ulnohumeral motion was 130° (range: 65° to 150°), average arc of forearm rotation was 148° (range: 100°-160°), mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 7.1 (range: 0-28.5), and mean Mayo Elbow Performance Score (MEPS) was 92 (range: 70-100). According to the Mayo Elbow Performance Index (MEPI), 10 patients were excellent in, seven patients were good, and one patient was fair. All patients had a stable elbow. No secondary coronoid fragment dislocation or implant failures was reported. Fracture healing was observed in all patients. CONCLUSIONS This study shows that coronoid fracture treatment with MCS may be a new, effective and easy therapeutic option in terrible triad injury. Key words:terrible triad of the elbow, coronoid process, radial head, functional outcome.
研究目的 本研究旨在分析连续18例肘关节恐怖三联征损伤患者的临床和影像学结果。这些患者的冠突骨折采用子母螺钉（MCS）进行修复。材料与方法 12例男性和6例女性（平均年龄：47.2岁）肘关节恐怖三联征损伤患者接受了平均17.6个月（范围：13 - 42个月）的随访。手术治疗包括使用MCS对冠突骨折进行切开复位内固定，对10例Mason II型桡骨头骨折使用MCS，3例Mason III型桡骨头骨折使用微型钢板。此外，所有患者均进行了外侧副韧带修复（n = 9，100%），对于持续不稳定的病例，进行了内侧副韧带修复（n = 3，33%）。结果 在最后一次随访时，尺肱关节平均活动弧度为130°（范围：65°至150°），前臂平均旋转弧度为148°（范围：100° - 160°），手臂、肩部和手部功能障碍（DASH）平均评分为7.1（范围：0 - 28.5），Mayo肘关节功能评分（MEPS）平均为92（范围：70 - 100）。根据Mayo肘关节功能指数（MEPI），10例患者为优，7例患者为良，1例患者为中。所有患者的肘关节均稳定。未报告继发性冠突碎片脱位或植入物失败情况。所有患者均观察到骨折愈合。结论 本研究表明，使用MCS治疗冠突骨折可能是肘关节恐怖三联征损伤一种新的、有效且简便的治疗选择。关键词：肘关节恐怖三联征，冠突，桡骨头，功能结果
