Department of Orthopedics (Division of Plastic and Hand Surgery), The Second Affiliated Hospital and YuYing Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Orthop Surg. 2022 Oct;14(10):2591-2597. doi: 10.1111/os.13463. Epub 2022 Sep 5.
The fixation of the coronoid fractures in terrible triad injuries is quite challenging. In this study, we introduce a minimally invasive technique using a syringe as a guide for insertion of the cannulated screw in an anterior to posterior fashion to fix the coronoid fracture in patients with terrible triad injuries.
In this retrospective study, clinical data of patients suffering from terrible triad injuries between 2012 and 2019 were analyzed. Fifteen patients with an average age of 38.2 years old (21-56 years) were enrolled in this study, of which 12 were males and three were females. The Regan-Morrey type II and type III coronoid fractures in these patients were treated with cannulated screws, inserted anteriorly using a 1 mL syringe as a guide. Outcome measures included pain, range of motion, stability and daily function using Mayo Elbow Performance scores (MEPs). The anteroposterior and lateral radiographs were used for evaluating a healing fracture.
After a mean follow up of 44.2 months (range 13-80), the mean elbow flexion was 128.2°, extension was 12.3°, forearm pronation was 74.6° and supination was 73.6°. A concentric reduction was maintained without severe pain, stiffness, and radiographic evidence of instability in all patients during the follow-up period. The mean MEPs was 89.7 points.
The anteroposterior cannulated screw fixation via simple syringe guide is a minimally invasive and safe option for surgical treatment of coronoid fractures in terrible triad injuries.
三联征损伤中冠状突骨折的固定极具挑战性。本研究中，我们介绍了一种微创技术，使用注射器作为引导从前向后插入空心螺钉以固定三联征损伤患者的冠状突骨折。
本回顾性研究分析了 2012 年至 2019 年期间患有三联征损伤的患者的临床资料。本研究共纳入 15 例平均年龄 38.2 岁（21-56 岁）的患者，其中 12 例为男性，3 例为女性。这些患者的 Regan-Morrey Ⅱ型和Ⅲ型冠状突骨折采用空心螺钉治疗，从前侧使用 1ml 注射器作为引导插入。采用 Mayo 肘功能评分（MEPs）评估疼痛、活动范围、稳定性和日常功能。通过前后位和侧位 X 线片评估骨折愈合情况。
平均随访 44.2 个月（范围 13-80 个月）后，平均肘部屈曲 128.2°，伸展 12.3°，前臂旋前 74.6°，旋后 73.6°。所有患者在随访期间均保持同心复位，无严重疼痛、僵硬和影像学不稳定证据。平均 MEPs 为 89.7 分。
通过简单的注射器引导从前向后进行空心螺钉固定是治疗三联征损伤中冠状突骨折的一种微创、安全的选择。
