复杂肘关节脱位合并的O'Driscoll Ⅰ型尺骨冠状突骨折固定要求及与肘关节稳定性的关系  

Fixation Requirement of Coronoid Process Fractures of O'Driscoll Type Ⅰ in Complex Elbow Dislocation and Its Relationship with Elbow Stability

作　　者：苏方贵 孙小东 余鹏 SU Fanggui SUN Xiaodong YU Peng(Yangjiang Hospital of TCM, Yangjiang 529500, Chin)

机构地区：[1]阳江市中医医院,广东阳江529500

出　　处：《临床医学工程》2017年第8期1125-1126,共2页Clinical Medicine & Engineering

摘　　要：目的探讨对复杂肘关节脱位合并的O'Driscoll Ⅰ型尺骨冠状突骨折患者进行内固定的要求及其与肘关节稳定性的关系。方法纳入复杂肘关节脱位合并的O'Driscoll Ⅰ型尺骨冠状突骨折患者共41例,分为保守治疗组17例(肘关节稳定)、未修复组15例(术中固定尺骨冠状突骨折块及前关节囊修复后关节稳定,未给予修复外侧韧带结构)、修复组9例(肘关节复发脱位需屈肘>60°才能复位,采用一期固定尺骨冠状突骨折块及修复内外两侧韧带结构)。结果三组患者的肘关节活动度、前臂旋转活动度和VAS评分比较无统计学差异(P>0.05),三组肘关节伸直活动度比较差异具有统计学意义(P<0.05),三组患者的Broberg-Morrey评分优良率比较无统计学差异(P>0.05)。结论 O'Driscoll Ⅰ型尺骨冠状突骨折内固定需根据患者脱位后肘关节的稳定性决定,针对稳定性较差的患者,固定O'Driscoll Ⅰ型尺骨冠状突骨折可以增加肘关节的稳定性。Objective To explore the requirement of internal fixation for patients with coronoid process fractures of O＇Driscoll type I in complex elbow dislocation and its relationship with elbow stability. Methods 41 cases of patients with coronoid process fractures of O＇Driscoll type I in complex elbow dislocation were selected and divided into three groups. 17 patients with stable elbow who received conservative treatment were selected as conservative group, 15 patients with subluxation who received fixation of coronoid process fracture and repair of the anterior capsule except the lateral collateral ligaments were set as the non-repair group, and 9 patients with recurrent dislocation and obvious instability （more than 60~ flexion who received one stage fixation of coronoid process fracture and repair of the medial and lateral collateral ligaments were set as the repair group. Results No statistical difference was found among three groups in the elbow arc, forearm rotation, VAS score or excellent and good rate of Broberg-Morrey score （P 〉0.05）, while there was statistical difference among three groups in the elbow extension arc （P〈0.05）. Conclusions Internal fixation ofcoronoid process fractures of O＇Driscoll Type I depends on stability of the elbow after dislocation. It can increase stability of the elbow in the complex elbow dislocation with poor stability.

关 键 词：肘关节脱位 尺骨冠状突骨折 关节稳定性 

分 类 号：R683.41[医药卫生—骨科学]