Department of Orthopaedic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Department of Pediatric Orthopaedic Surgery, Shenzhen Children's Hospital, Shenzhen, 518046, China.
J Orthop Surg Res. 2021 Mar 30;16(1):232. doi: 10.1186/s13018-021-02373-x.
The ipsilateral olecranon with associated radial neck fractures does not include in the Bado classification of Monteggia fractures and equivalent lesions. The primary aims of this retrospective multicenter study were to characterize this type of injury and, noting its unique properties, evaluate the results of the treatment, determine the prognostic factors that influence the radiological and clinical outcome, and also give treatment strategies.
Between July 2011 and July 2016, forearm fracture patient charts were retrospectively reviewed from seven pediatric trauma centers. Patients diagnosed with ipsilateral olecranon with associated radial neck fractures and followed up for at least 24 months were included. Fracture characteristics, treatment, outcome, and complications were assessed. The clinical outcome of treatments was evaluated by the Mayo Elbow Performance Score (MEPS) and the Flynn criteria. Fisher's exact test and ANOVA test were used; significance was defined as P < 0.05.
One hundred thirty-seven consecutive patients (54 girls and 83 boys) from 8292 forearm fractures patients, the mean age of 7.5 years (1.5 to 14.8), with fractures of the ipsilateral olecranon with associated radial neck fractures were identified. One hundred twenty-five patients had radiologic and clinical follow-up. According to a simplified classification system with "operate" and "don't operate" groups, including five subtypes proposed in this study, ipsilateral olecranon with associated radial neck fractures subtypes could be classified with significantly different characteristics and outcome in treatment and complications.
Fractures of the ipsilateral olecranon associated with the radial neck are not so rare as previously reported. Complications and poor outcomes were easy to encounter without knowing this type of fracture. Appropriate treatment strategies could be made according to a simple classification system based on the treatment result of follow-up.
Retrospective comparative study; Level III.
伴有桡骨颈骨折的同侧尺骨鹰嘴骨折不包括在 Monteggia 骨折和等效损伤的 Bado 分类中。本回顾性多中心研究的主要目的是描述这种类型的损伤，并注意到其独特的性质，评估治疗结果，确定影响放射学和临床结果的预后因素，以及提供治疗策略。
2011 年 7 月至 2016 年 7 月，从 7 个小儿创伤中心回顾性地查阅了前臂骨折患者的病历。纳入了诊断为同侧尺骨鹰嘴伴桡骨颈骨折并至少随访 24 个月的患者。评估了骨折特征、治疗、结果和并发症。采用 Mayo 肘部功能评分（MEPS）和 Flynn 标准评估治疗的临床结果。Fisher 确切检验和 ANOVA 检验；显著性定义为 P < 0.05。
在 8292 例前臂骨折患者中，连续有 137 例（54 例女性和 83 例男性）患者诊断为同侧尺骨鹰嘴伴桡骨颈骨折，平均年龄为 7.5 岁（1.5 至 14.8 岁）。125 例患者有影像学和临床随访。根据本研究提出的简化分类系统，包括“手术”和“不手术”两组，包括 5 个亚型，同侧尺骨鹰嘴伴桡骨颈骨折亚型可以进行分类，治疗和并发症的特征和结果有明显的不同。
同侧尺骨鹰嘴伴桡骨颈骨折并不像以前报道的那么罕见。如果不知道这种类型的骨折，很容易发生并发症和不良后果。可以根据基于随访治疗结果的简单分类系统制定适当的治疗策略。
回顾性比较研究；III 级。
