背景:喙突在维持肘关节的稳定性方面起着重要作用。冠状突骨折通常通过手术方法治疗,包括切开复位和内固定,旨在恢复稳定,灵活,和可加载接头。在这项研究中,我们比较了前部,中间,和内固定的后路方法修复尺骨冠状突骨折。
方法:在这项回顾性研究中,招募了147例尺骨冠状突骨折患者,并将其分为前路组(n=73),中间组(n=32),后路组(n=42)按手术入路采用内固定。这些患者在切口方面进行了评估,手术时间,估计失血量,骨折愈合,术后并发症。Mayo肘部性能评分用于评估与肘部损伤相关的任何形式的残疾。采用多因素logistic回归分析探讨影响尺骨冠突骨折疗效的因素。
结果:在内侧入路组中,手术时间较长,围手术期出血量和术后引流量较前、后组均明显增加。与中间组相比,前路组术后恢复更好,和后面的组。与前路组相比,后路组骨折愈合时间进一步缩短,而肘关节屈伸和前臂旋转度改善。与前路和内侧组相比,后路组的并发症明显减少。影响尺骨冠突骨折疗效的因素包括Regan-Morrey分型,围手术期失血,和内固定方法。
结论:总之,所使用的方法影响骨折愈合或接骨术后的结果。后路内固定方法在尺骨冠状突骨折患者中产生了令人满意的功能结果。
BACKGROUND: The coracoid process plays an important role in maintaining the stability of the elbow joint. A fracture of the coronoid process is often treated via surgical approaches, including open reduction and internal fixation, which aim to regain a stable, flexible, and loadable joint. In this
study, we compared the anterior, medial, and posterior approaches of internal fixation in the repair of fractures of the coronoid process of the ulna.
METHODS: In this retrospective
study, 147 patients with fractures in the coronoid process of the ulna were recruited and classified into the anterior group (n = 73), the medial group (n = 32), and the posterior group (n = 42) according to the surgical approach used for internal fixation. These patients were assessed with respect to incision, operative time, estimated blood loss, fracture healing, and postoperative complications. The Mayo Elbow Performance Score was used to evaluate any form of disability associated with elbow injuries. Multivariate logistic regression analysis was performed to investigate the factors influencing the efficacy of fractures of the coronoid process of the ulna.
RESULTS: In the medial approach group, the operative time was longer, and perioperative blood loss and postoperative drainage volume were obviously increased compared with the anterior and posterior groups. The anterior group exhibited a better postoperative recovery compared with the medial, and posterior groups. Compared with the anterior group, fracture-healing time in the posterior group was further reduced, whereas elbow joint flexion extension and forearm rotation degree improved. Complications were significantly reduced in the posterior approach group compared with the anterior and medial groups. The factors influencing the efficacy of fractures of the coronoid process of the ulna included the Regan-Morrey classification, perioperative blood loss, and the internal fixation approach.
CONCLUSIONS: In summary, the approach used influences fracture healing or the outcome after osteosynthesis. The posterior internal fixation method produced satisfactory functional outcomes in patients with fractures of the coronoid process of the ulna.