Kingery Matthew T, Lowe Dylan T, Egol Kenneth A
Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, New York, NY.
J Orthop Trauma. 2022 Aug 1;36(Suppl 3):S7-S8. doi: 10.1097/BOT.0000000000002385.
Anteromedial coronoid facet fractures typically occur with varus, pronation, and axial forces applied to the elbow. Due in part to the high rate of concomitant lateral collateral ligament (LCL) injuries, untreated anteromedial facet fractures can result in varus and posteromedial rotatory elbow instability. Although small fractures that are not amenable to open reduction and internal fixation can be treated with isolated LCL repair, larger fragments are treated with buttress plating on the anteromedial surface of the coronoid with or without LCL repair. The "over-the-top" approach via a split in the flexor pronator mass is the preferred method of accessing the anteromedial facet. Although data regarding the functional outcomes after operative fixation of the anteromedial facet are limited, observational studies have demonstrated good restoration of elbow stability and motion.
前内侧冠状突面骨折通常发生在肘施加内翻、旋前和轴向力的情况下。部分原因是由于伴有外侧副韧带(LCL)损伤的发生率较高,未经治疗的前内侧关节面骨折可导致肘内翻和后内侧旋转不稳定。虽然不能进行切开复位内固定的小骨折可以通过单独的 LCL 修复来治疗,但较大的骨折块则需要在前冠状突的前内侧表面用支撑钢板进行治疗,无论是否进行 LCL 修复。通过屈肌旋前肌群的分裂进行“过顶”入路是进入前内侧关节面的首选方法。虽然关于前内侧关节面手术固定后功能结果的数据有限,但观察性研究已经证明了良好的肘部稳定性和运动功能的恢复。