【摘要】：目的探討改良肘關(guān)節(jié)前內(nèi)側(cè)入路治療尺骨冠狀突骨折的臨床療效。方法 2010年1月—2014年12月,采用改良肘關(guān)節(jié)前內(nèi)側(cè)入路治療13例尺骨冠狀突骨折患者。其中,男10例,女3例;年齡18~57歲,平均37.2歲。致傷原因:交通事故傷5例,高處墜落傷7例,硬物撞擊傷1例。損傷類型:肘關(guān)節(jié)恐怖三聯(lián)征7例,冠狀突骨折合并同側(cè)橈骨頭骨折4例,尺、橈骨近端關(guān)節(jié)內(nèi)粉碎雙骨折1例,冠狀突骨折合并同側(cè)橈骨遠端骨折1例。尺骨冠狀突骨折按照Regan-Morrey分型:Ⅱ型2例,Ⅲ型11例;按照O’Driscoll分型:冠狀突前內(nèi)側(cè)面骨折10例(Ⅱb型8例、Ⅱc型2例),基底部骨折3例。記錄尺骨冠狀突骨折復(fù)位內(nèi)固定手術(shù)時間、術(shù)中出血量以及相關(guān)并發(fā)癥發(fā)生情況。通過X線片及臨床檢查判斷骨折是否愈合,記錄愈合時間。測量肘關(guān)節(jié)屈伸、旋轉(zhuǎn)活動度,根據(jù)Mayo肘關(guān)節(jié)功能指數(shù)(MEPI)評價肘關(guān)節(jié)功能。結(jié)果手術(shù)時間為30~55 min,平均38.7 min;術(shù)中出血量為90~160 mL,平均109.3 mL。術(shù)后切口均Ⅰ期愈合,無醫(yī)源性血管、神經(jīng)損傷發(fā)生�；颊呔@隨訪,隨訪時間13~24個月,平均16.9個月。骨折均達臨床愈合,愈合時間8~16周,平均11.2周;2例異位骨化形成。末次隨訪,肘關(guān)節(jié)活動度屈119~145°,平均132.4°;伸 8~15°,平均7°;前臂旋前68~90°,平均78.6°;旋后76~90°,平均84.3°。MEPI為70~100分;其中優(yōu)9例,良3例,可1例,優(yōu)良率92.3%。結(jié)論改良肘關(guān)節(jié)前內(nèi)側(cè)入路治療尺骨冠狀突骨折,可以避開肘部重要血管、神經(jīng),直視下進行骨折塊復(fù)位、固定,是一種安全、簡便、有效的手術(shù)入路。
[Abstract]:Objective to investigate the clinical effect of modified anterior medial elbow approach in the treatment of coronoid process fracture of ulna. Methods from January 2010 to December 2014, 13 patients with fracture of ulnar coronal process were treated with modified anterior medial approach of elbow joint. Among them, 10 cases were males and 3 cases were females, the age was 1857 years (mean 37.2 years). The causes of injury were traffic accident in 5 cases, falling injury in 7 cases and hard object impact injury in 1 case. The types of injury were as follows: 7 cases of elbow joint terror, 4 cases of coronal process fracture with ipsilateral radial head fracture, 1 case of comminuted double fracture of ulnar and proximal end of radius, 1 case of coronal process fracture with ipsilateral distal radius fracture. According to Regan-Morrey classification of ulnar coronal process fracture: type 鈪，

本文編號：2221613