Shen Jian-Jian, Qiu Qing-Mi, Gao Yi-Bin, Tong Song-Lin, Huang Jie-Feng
1 Department of Orthopaedics, Wenzhou Medical University-Affiliated Cixi Hospital, Cixi, Zhejiang, China.
2 Department of Orthopaedics, The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang China.
J Orthop Surg (Hong Kong). 2019 Jan-Apr;27(1):2309499018825223. doi: 10.1177/2309499018825223.
The goal of this study was to evaluate the clinical effect of Regan-Morrey type II comminuted coronoid process fracture treated with mini plate through the direct anterior approach (DAA).
Ten patients who underwent open reduction and internal fixation (ORIF) with mini plate through the DAA between February 2013 and August 2016 was included. There were three women and seven men, with an average age of 34.4 ± 7.5 years. At the final follow-up, the Mayo Elbow Performance Index (MEPS), Visual Analogue Scale (VAS) score, Disability of the Arm, Shoulder, and Hand (DASH) score, and the elbow range of motion were noted.
The mean follow-up was 26.3 ± 2.2 (range 24-31) months. The mean elbow arc of motion was 118.5° with a mean arc of extension of 4° ± 5.2° and flexion of 122.5° ± 7.2°.The mean forearm pronation was 72° ± 7.2°, and the mean supination was 68° ± 6.3° with a mean forearm rotation arc of 140°. The average postoperative score according to the MEPS was 91 ± 5.7 points (range 80-100 points), and all patients achieved satisfactory scores (8 excellent and 2 good). The final average VAS score was 0.6 ± 1 (range 0-3). The final average DASH score was 4.0 ± 1.6 (range 2.3-7.4). None of the patients complained about elbow instability that required secondary surgery. No complications of infection, joint incongruency, fracture nonunion, median nerve palsy, or implant failure were reported.
ORIF with mini plate through the DAA for the treatment of the type II comminuted coronoid process fractures can achieve satisfactory outcomes.
本研究的目的是评估经直接前路（DAA）使用微型钢板治疗Regan-Morrey II型粉碎性冠突骨折的临床效果。
纳入2013年2月至2016年8月期间经DAA使用微型钢板进行切开复位内固定（ORIF）的10例患者。其中女性3例，男性7例，平均年龄34.4±7.5岁。在末次随访时，记录梅奥肘关节功能指数（MEPS）、视觉模拟评分（VAS）、上肢、肩部和手部功能障碍评分（DASH）以及肘关节活动范围。
平均随访时间为26.3±2.2（范围24 - 31）个月。平均肘关节活动弧度为118.5°，平均伸展弧度为4°±5.2°，屈曲弧度为122.5°±7.2°。平均前臂旋前为72°±7.2°，平均旋后为68°±6.3°，平均前臂旋转弧度为140°。根据MEPS的术后平均评分为91±5.7分（范围80 - 100分），所有患者均获得满意评分（8例优，2例良）。最终平均VAS评分为0.6±1（范围0 - 3）。最终平均DASH评分为4.0±1.6（范围2.3 - 7.4）。没有患者抱怨肘关节不稳定需要二次手术。未报告感染、关节不匹配、骨折不愈合、正中神经麻痹或植入物失败等并发症。
经DAA使用微型钢板对II型粉碎性冠突骨折进行ORIF可取得满意疗效。
