Tianjin University of Traditional Chinese Medicine, Tianjin, 301617, China.
Tianjin 4th Centre Hospital, Tianjin, 300140, China.
Int Orthop. 2023 Aug;47(8):2065-2071. doi: 10.1007/s00264-023-05855-1. Epub 2023 Jun 4.
The purpose of this study is to compare the effect of buttress plate and cannulated screw in the treatment of anteromedial coronoid fracture with posteromedial rotatory instability (PMRI).
We retrospectively evaluated patients who were diagnosed with O'Driscoll type 2 fractures combined with elbow posteromedial rotatory instability and underwent surgery for anteromedial coronoid fracture between August 2014 and March 2019. They were divided into buttress plate (n=16) and cannulated screw (n=11) groups. The elbow range of motion, visual analog scale (VAS), Mayo elbow performance score (MEPS), and disabilities of the arm, shoulder, and hand score (DASH) were used for clinical outcome assessment.
There were no significant differences in clinical outcomes. However, the surgical time was significantly shorter in cannulated screw group (85.45±4.156) compared to the buttress plate group (93.81±8.863, P=0.008), and the surgical time was associated with internal fixation (P=0.008).
Although there was selection of cases in that small fragments were treated with buttress plate and large fragments with cannulated screw, the buttress plate and cannulated screw have comparable functional outcomes on fixation of the anteromedial coronoid fracture with elbow PMRI. The fixation of the anteromedial coronoid fracture with large fragments using the cannulated screw has a shorter operation time.
本研究旨在比较支撑钢板和空心螺钉治疗伴有后内侧旋转不稳定的前内侧冠状突骨折的效果。
我们回顾性评估了 2014 年 8 月至 2019 年 3 月间被诊断为 O'Driscoll 2 型骨折合并肘后内侧旋转不稳定并接受前内侧冠状突骨折手术的患者。他们被分为支撑钢板（n=16）和空心螺钉（n=11）组。采用肘活动度、视觉模拟评分（VAS）、 Mayo 肘功能评分（MEPS）和上肢残疾问卷（DASH）评估临床结果。
两组在临床结果方面无显著差异。然而，空心螺钉组的手术时间明显短于支撑钢板组（85.45±4.156 比 93.81±8.863，P=0.008），且手术时间与内固定方式相关（P=0.008）。
尽管在治疗小骨块时选择使用支撑钢板，而在治疗大骨块时选择使用空心螺钉，但支撑钢板和空心螺钉在治疗伴有肘后内侧旋转不稳定的前内侧冠状突骨折时，其固定效果具有可比性。对于大骨块的前内侧冠状突骨折，使用空心螺钉固定具有更短的手术时间。
