PDF(Pubmed)
Abstract：
OBJECTIVE: Numerous surgical techniques for addressing ulnar coronoid process fractures are available; however, a consensus on the optimal approach remains elusive. This study aimed to use the anterior neurovascular interval approach for the surgical management of ulnar coronoid process fractures and to evaluate its clinical outcomes over short- to mid-term follow-up.
METHODS: This retrospective clinical study included 20 patients with ulnar coronoid process fractures who were treated using the anterior neurovascular interval approach between January 2018 and December 2022. Participants comprised 16 males and four females, aged between 20 and 64 years (mean, 34.3 ± 12.44 years). Clinical and radiological evaluations were based on elbow joint range of motion (ROM), Visual analogue scale (VAS), and Mayo elbow performance score (MEPS). A paired t-test was used to compare the pre-operative and final follow-up VAS and MEPS scores.
RESULTS: The follow-up duration for all patients was at least 12 months (average, 12.65 ± 1.60 months). At the final follow-up, measurements of elbow ROM included a mean extension of 2.85 ± 3.17°, mean flexion of 135 ± 7.25°, mean pronation of 86.4 ± 4.56°, and mean supination of 84.85 ± 5.54°. All participants reached their target MEPS, with an average score of 97.25 ± 4.72 points, and the final mean VAS score was 0.2 ± 0.52 points. The VAS score was significantly lower and MEPS score was higher at the final follow-up than those before surgery (p < 0.05). Throughout the follow-up period, all the fractures united, and the stability of the affected elbows was satisfactory.
CONCLUSIONS: Employing the anterior neurovascular interval approach for open reduction and internal fixation to manage coronoid process fractures effectively facilitates anatomical restoration and robust fixation of ulnar coronoid process fractures.
METHODS: This retrospective clinical study included 20 patients with ulnar coronoid process fractures who were treated using the anterior neurovascular interval approach between January 2018 and December 2022. Participants comprised 16 males and four females, aged between 20 and 64 years (mean, 34.3 ± 12.44 years). Clinical and radiological evaluations were based on elbow joint range of motion (ROM), Visual analogue scale (VAS), and Mayo elbow performance score (MEPS). A paired t-test was used to compare the pre-operative and final follow-up VAS and MEPS scores.
RESULTS: The follow-up duration for all patients was at least 12 months (average, 12.65 ± 1.60 months). At the final follow-up, measurements of elbow ROM included a mean extension of 2.85 ± 3.17°, mean flexion of 135 ± 7.25°, mean pronation of 86.4 ± 4.56°, and mean supination of 84.85 ± 5.54°. All participants reached their target MEPS, with an average score of 97.25 ± 4.72 points, and the final mean VAS score was 0.2 ± 0.52 points. The VAS score was significantly lower and MEPS score was higher at the final follow-up than those before surgery (p < 0.05). Throughout the follow-up period, all the fractures united, and the stability of the affected elbows was satisfactory.
CONCLUSIONS: Employing the anterior neurovascular interval approach for open reduction and internal fixation to manage coronoid process fractures effectively facilitates anatomical restoration and robust fixation of ulnar coronoid process fractures.
摘要：
目的：目前已有许多治疗尺骨冠突骨折的手术技术；关于最佳方法的共识仍然难以捉摸。本研究旨在使用前神经血管间隔方法治疗尺骨冠突骨折，并评估其短期至中期随访的临床结果。
方法：这项回顾性临床研究包括2018年1月至2022年12月采用前神经血管间隔入路治疗的20例尺骨冠突骨折患者。参与者包括16名男性和4名女性，年龄在20至64岁之间(平均，34.3±12.44年）。临床和放射学评估基于肘关节活动范围（ROM），视觉模拟量表(VAS)和梅奥肘部性能评分（MEPS）。使用配对t检验比较术前和最终随访的VAS和MEPS评分。
结果：所有患者的随访时间至少为12个月（平均，12.65±1.60个月）。在最后的后续行动中，肘部ROM的测量包括2.85±3.17°的平均延伸，平均屈曲135±7.25°，平均内旋86.4±4.56°，平均旋后84.85±5.54°。所有参与者都达到了他们的目标MEPS，平均得分为97.25±4.72分，最终平均VAS评分为0.2±0.52分。末次随访时VAS评分明显低于术前,MEPS评分明显高于术前(p<0.05)。在整个随访期间，所有的骨折联合起来，受影响肘部的稳定性令人满意。
结论：采用前神经血管间隔入路切开复位内固定治疗冠状突骨折有效地促进了尺骨冠状突骨折的解剖恢复和坚固固定。
方法：这项回顾性临床研究包括2018年1月至2022年12月采用前神经血管间隔入路治疗的20例尺骨冠突骨折患者。参与者包括16名男性和4名女性，年龄在20至64岁之间(平均，34.3±12.44年）。临床和放射学评估基于肘关节活动范围（ROM），视觉模拟量表(VAS)和梅奥肘部性能评分（MEPS）。使用配对t检验比较术前和最终随访的VAS和MEPS评分。
结果：所有患者的随访时间至少为12个月（平均，12.65±1.60个月）。在最后的后续行动中，肘部ROM的测量包括2.85±3.17°的平均延伸，平均屈曲135±7.25°，平均内旋86.4±4.56°，平均旋后84.85±5.54°。所有参与者都达到了他们的目标MEPS，平均得分为97.25±4.72分，最终平均VAS评分为0.2±0.52分。末次随访时VAS评分明显低于术前,MEPS评分明显高于术前(p<0.05)。在整个随访期间，所有的骨折联合起来，受影响肘部的稳定性令人满意。
结论：采用前神经血管间隔入路切开复位内固定治疗冠状突骨折有效地促进了尺骨冠状突骨折的解剖恢复和坚固固定。
