Center for Orthopedic and Trauma Surgery, University of Cologne, Faculty of Medicine and University Hospital, Cologne, Germany.
Z Orthop Unfall. 2022 Feb;160(1):35-39. doi: 10.1055/a-1263-1742. Epub 2020 Oct 15.
This study aimed to describe the involvement of the lesser sigmoid notch in fractures to the coronoid process. We hypothesized that injuries to the lateral aspect of the coronoid process regularly involve the annular ligament insertion at the anterior lesser sigmoid notch.
Patients treated for a coronoid process fracture at our institution between 06/2011 and 07/2018 were included. We excluded patients < 18 years, patients with arthritic changes or previous operative treatment to the elbow, and patients with concomitant injuries to the proximal ulna. In patients with involvement of the lesser sigmoid notch, the coronoid height and fragment size (anteroposterior, mediolateral, and craniocaudal) were measured.
Seventy-two patients (mean age: 47 years ± 17.6) could be included in the study. Twenty-one patients (29.2%) had a fracture involving the lateral sigmoid notch. The mean anteroposterior fragment length was 7 ± 1.6 mm. The fragment affected a mean of 43 ± 10.8% of the coronoid height. The mean mediolateral size of the fragment was 10 ± 5.0 mm, and the mean cranio-caudal size was 7 ± 2.7 mm.
Coronoid fractures regularly include the lesser sigmoid notch. These injuries possibly affect the anterior annular ligament insertion which is important for the stability of the proximal radioulnar joint and varus stability of the elbow.
本研究旨在描述乙状切迹在冠状突骨折中的作用。我们假设，冠状突外侧的损伤通常会累及前小乙状切迹处的环形韧带附着处。
我们纳入了 2011 年 6 月至 2018 年 7 月期间在我院接受治疗的冠状突骨折患者。我们排除了年龄<18 岁、有关节炎改变或肘部以前手术治疗、以及伴有尺骨近端损伤的患者。在涉及小乙状切迹的患者中，测量冠状突高度和骨折块大小（前后、内外和头侧尾侧）。
本研究共纳入 72 例患者（平均年龄：47 岁±17.6 岁）。21 例（29.2%）患者的骨折涉及外侧乙状切迹。前后骨折块长度平均为 7±1.6mm。骨折块累及冠状突高度的平均比例为 43±10.8%。骨折块的平均内外径为 10±5.0mm，平均头侧尾侧径为 7±2.7mm。
冠状突骨折通常包括小乙状切迹。这些损伤可能会影响到前环形韧带附着处，这对于近端桡尺关节的稳定性和肘内翻的稳定性很重要。
