| 摘要: |
| 目的比较肘关节改良前侧手术入路与内侧手术入路治疗尺骨冠状突骨折的疗效差异。方法收集2010年6月至2014年2月采用改良前侧手术入路与内侧手术入路治疗的Regan-Morrey分型Ⅱ、Ⅲ型尺骨冠状突骨折患者的资料。其中改良前侧手术入路组（A组）21例，男14例，女7例，年龄26～60岁，平均43.6岁；内侧手术入路组（B组）21例，男12例，女9例，年龄32～58岁，平均41.5岁。比较两组的手术时间、切口长度、术中出血量、骨折愈合时间、肌力减弱率、患侧肘关节疼痛发生率、患侧肘关节旋转及屈伸活动度减少度数、梅奥肘关节功能评分等。结果术后患者均获得随访，A组随访时间（14.0±4.1）个月，B组随访（13.8±3.8）个月。两组骨折愈合良好，无畸形愈合及切口感染等并发症。A组手术时间明显短于B组（P＝0.001），切口长度、术中出血量、骨折愈合时间、肌力减弱率两组无统计学差异。A组患侧肘关节旋转及屈伸活动度减少度数、肘部疼痛发生率均明显优于B组(均P＜0.05）。梅奥肘关节功能评分，A组优、良、可、差例数分别为10、9、1、1例，B组分别为8、9、2、2例。梅奥肘关节功能评分优良率A组为90.4％（19/21），B组为80.9％（17/21）。结论两种手术入路治疗效果均满意，但改良前侧入路治疗尺骨冠状突骨折相对安全且操作简单，术后并发症少，肘关节功能恢复好，值得在临床上推广。 |
| 关键词: 肘关节 尺骨冠状突 骨折 |
| DOI： |
| 分类号: |
| 基金项目: |
|
| Comparison of two surgical approaches for treatment of ulnar coronoid process fractures |
|
ZHU Ren, ZHOU Junming, YU Wenjun
|
|
Yiwu Chouzhou Hospital
|
| Abstract: |
| Objective To compare two surgical approaches in treatment of ulnar coronoid process fractures. Methods Forty two patients with Morrey type II and III ulnar coronoid fractures were surgically treated from June 2010 to February 2014 in our hospital, including 21 cases via modified anterior approach (group A) and 21 cases via medial approach (group B). In group A there 14 males and 7 females, aged 43.6 years (26 ~ 65 years), in group B there was 12 males and 9 females aged 41.5 years (32~58 years). The operation time, incision length, intraoperative blood loss, fracture healing time, reduced muscle strength rate, pain of elbow joint, movement degree of elbow joint, and the Mayo Elbow Performance Index(MEPI) were recorded in two groups. Results Patients in group A were followed-up for 14.0 ±4.1 months, and those in group B were followed-up for 13.8 ±3.8 months. Fracture healing was good for both groups, and there were no bad wound healing and other complications. The
operation time of group A was significantly shorter than that of group B (P=0.001), there were no significant differences in incision length, blood loss, fracture healing time and reduced muscle strength rate between two groups. Compared with the patients of group B, the reduced degree of flexion and extension and the forearm rotation, and the pain of the elbow were significantly better than those in group B (P＜0.05). According to MEPI, the cases of excellent, good, fair and poor were 10/9/1/1, respectively in group A, and 8/9/2/2 in group B. The excellent and good rate was 90.4% (19/21) in group A and 80.9% (17/21) in group B. Con- clusion The results of both surgical approaches are satisfactory, however, the modified anterior approach is relatively safe and simple with less postoperative complications and good functional recovery of elbow joint for treatment of coronoid process frac- tures. |
| Key words: Elbow joint Ulnar coronoid process Fracture |
