个体化方案治疗不同类型尺骨冠状突骨折的肘关节恐怖三联征  

The individualized regimen for treatment of terrible triad injury of elbow with different types of ulna coronal process fracture

作　　者：成欣[1] 周立建[1] 高炳俊[1] 蒋波逸 CHENG Xin;ZHOU Li-jian;GAO Bing-jun;JIANG Bo-yi(Dept of Orthopaedics,the People′s Hospital of Danyang City,Zhenjiang,Jiangsu 212300,China)

机构地区：[1]丹阳人民医院骨科,江苏镇江212300

出　　处：《临床骨科杂志》2021年第2期247-250,共4页Journal of Clinical Orthopaedics

摘　　要：目的分析个体化方案治疗不同类型尺骨冠状突骨折的肘关节恐怖三联征的临床疗效。方法将42例肘关节恐怖三联征患者根据尺骨冠状突骨折Regan-Morrey分型的不同选择个体化方案治疗。记录肘关节屈伸及前臂旋转活动范围,采用Mayo评分评价肘关节功能,观察并发症发生情况。结果患者均获得随访,时间4~6(4.93±0.75)年。术后切口感染3例(Ⅰ型1例,Ⅱ型1例,Ⅲ型1例);迟发性尺神经炎2例(均为Ⅱ型);创伤性关节炎2例(Ⅱ型1例,Ⅲ型1例)。末次随访时,Mayo评分和优良率3种类型比较差异均无统计学意义(P>0.05)。术后3、6、9个月,肘关节伸直、屈曲活动度尺骨冠状突骨折Ⅰ型患者均差于Ⅱ、Ⅲ型患者(P<0.05),Ⅱ、Ⅲ型患者比较差异无统计学意义(P>0.05);术后1、12个月以及末次随访时3种类型比较差异均无统计学意义(P>0.05)。前臂旋转活动度术后各时间点3种类型比较差异均无统计学意义(P>0.05)。结论手术治疗肘关节恐怖三联征时,尺骨冠状突Regan-Morrey分型是制定个体化治疗方案的重要依据。Objective To analyze the clinical efficacy of individualized regimen for treatment of terrible triad injury of elbow with different types of ulna coronal process fractures.Methods The 42 cases of terrible triad injury of elbow were treated with individualized surgery plan based on Regan-Morrey classification for ulna coronal process fracture.Dynamic motion scope changes of flexion-extension of elbow and rotation of forearm were observed.Elbow function were assessed with Mayo score criterion.Complications situation were observed.Results All cases were followed up for 4~6(4.93±0.75)years.There were 3 cases of incision infections(1 case occurred in typeⅠ,Ⅱ,Ⅲpatient,respectively),2 cases of delayed ulnar neuritis(both were typeⅡ)and 2 cases of traumatic arthritis(typeⅡ1 case,and typeⅢ1 case).At the last follow-up,there were no statistically significant differences in Mayo scales and excellent-good ratio among three kinds of classification(P>0.05).At 3,6,9 months,the activity of flexion-extension of elbow in the patients with typeⅠulna coronal process fracture was poorer than those of patient with typeⅡ,Ⅲ(P<0.05),while there was no difference for patients with typeⅡ,Ⅲ(P>0.05);there were no differences among the three types at 1,12 postoperation and last follow-up(P>0.05).For the activity of the forearm,there were no differences among the three kinds of fractures at the various time points(P>0.05).Conclusions In surgical treatment of terrible triad injury of elbow,Regan-Morrey classification of ulna coronal process fracture is an important basis for making individual treatment plan.

关 键 词：肘关节恐怖三联征 尺骨冠状突骨折 

分 类 号：R683.41[医药卫生—骨科学] R687.3[医药卫生—外科学]