前后路联合手术治疗尺骨鹰嘴并冠状突骨折  

Combined Anterior and Posterior Surgical Approach for Ulnar Olecranon and Coronoid Fracture

作　　者：衡立松[1] 张军[1] 朱养均[1] 张堃[1] 

机构地区：[1]西安交通大学医学院附属红会医院创伤骨科上肢病区,陕西西安710054

出　　处：《实用骨科杂志》2016年第2期111-114,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨应用前后路联合手术方式治疗尺骨鹰嘴并冠状突骨折的疗效。方法回顾性分析2012年5月至2014年8月采用前后路联合手术方法治疗32例尺骨鹰嘴并冠状突骨折,男21例,女11例;年龄26~57岁,平均37.7岁。所有患者均采用前后联合入路,冠状突骨折使用微型接骨板给予固定,尺骨鹰嘴骨折使用解剖接骨板给予固定,术中均达到牢固固定。记录骨折复位、固定后是否有骨折复位丢失、骨折愈合时间和并发症情况。末次随访时采用Mayo肘关节功能评分（mayo elbow performance score,MEPS）评定肘关节功能。结果 28例患者术后获8~25个月（平均18个月）随访,4例失访。所有患者骨折均获骨性愈合,愈合时间为6~18周,平均12.8周。末次随访时肘部屈曲活动度113°~128°,平均125°;肘部伸直活动度0°~30°,平均6°;前臂旋前54°~82°,平均75°;旋后69°~94°,平均81°。根据MEPS评分评定疗效,优20例,良4例,可2例,差2例,优良率为85.7%。所有患者均无伤口深部感染,2例患者出现肘关节僵硬。结论应用前后路联合手术治疗尺骨鹰嘴并冠状突骨折,可以有效复位及固定牢靠,有利于肘关节早期功能锻炼。Objective To explore the clinical efficacy of combined surgical approach of anterior and posterior for treatment of olecranon and coronoid fracture. Methods From May 2012 to August 2014,32 patients with ulnar olecranon and coronoid fracture were treated in our department. There were 21 males and 11 females with an average age of 37.7 years old（26 to 57 ）. All the patients were treated through combined surgical approach of anterior and posterior, using micro plate and anatomical plate to fix ulnar coronoid and olecranon fracture. Reduction reduction loss, fracture healing time and complications were documented. The elbow function was evaluated at the last follow-up by Mayo elbow performance score （MEPS）. Results Twenty-eight patients were followed up for 8 to 25 months （average, 18 months）, and 4 patients were lost. All the 28 patients obtained bony union after 6 to 18 weeks （ average, 12.8 weeks）. At the last follow-up, elbow flexion ranged from 113° to 128° （average, 125°）, elbow extension from 0° to 30°（ average, 6 o）, forearm pronation from 54° to 82°（ average,75°）, and supina- tion from 69° to 94° （ average, 81° ）. According to MEPS,20 patients were excellent,4 good,2 fair, and 2 poor. The excellent to good rate was 85.7%. None of the patients had deep wound infection. Two patients had elbow stiffness. Conclusion Com- bined surgical approach of anterior and posterior for treatment of olecranon and coronoid fracture can reduce effectively, fix firmly and enable function exercise of the elbow early.

关 键 词：肘关节 尺骨鹰嘴 尺骨冠状突 骨折固定术 前后路 

分 类 号：R683.41[医药卫生—骨科学]