Lin Chun-Cheng, Cheng Ming-Fai, Wang Chien-Shun, Chiang Chao-Ching, Su Yu-Ping
Division of Orthopaedic Trauma, Department of Orthopaedics and Traumatology, Taipei Veterans General Hospital, Taipei 112, Taiwan.
National Defense Medical Center, School of Medicine, Taipei 112, Taiwan.
Life (Basel). 2024 Jul 29;14(8):954. doi: 10.3390/life14080954.
The study aims to explain whether or not minimal invasive surgery (MIS) would be feasible in elbow fracture-dislocation with coronoid process fracture.
At Taipei Veterans General Hospital, patients who had elbow dislocations with coronoid process fractures underwent a single surgeon's MIS techniques which included the fluoroscopy-guided ulnar anteromedial (FGUAM) approach in the stage of reducing the coronoid process. When there is a proximal ulnar fracture, the posterior incision should be necessary, followed by the incision over the lateral or medial elbow for treating radial fractures or ligament injuries.
The Flow Diagram for approach recommendation was established on the basis of defining MIS as that which does not include cross-plane dissection. The importance of anterior rigid fixation for the coronoid process was also emphasized.
MIS can be achieved by multiple limited surgical incisions. Although the posterior extensile approach is necessary in situations of ulnar metaphysis or ligament avulsion fracture, the FGUAM approach decreases the cross-plane dissection.
本研究旨在解释微创手术（MIS）在伴有冠状突骨折的肘关节骨折脱位中是否可行。
在台北荣民总医院，患有肘关节脱位并伴有冠状突骨折的患者接受了由单一外科医生实施的MIS技术，其中在复位冠状突阶段采用了透视引导下尺骨前内侧（FGUAM）入路。当存在尺骨近端骨折时，需要后侧切口，随后在肘外侧或内侧做切口以治疗桡骨骨折或韧带损伤。
基于将MIS定义为不包括跨平面解剖，建立了入路推荐流程图。还强调了冠状突前方坚强固定的重要性。
MIS可通过多个有限的手术切口实现。尽管在尺骨干骺端或韧带撕脱骨折的情况下后侧扩大入路是必要的，但FGUAM入路减少了跨平面解剖。
