肘关节前内侧入路微创治疗尺骨冠状突骨折手术体会

目的探讨肘关节尺骨冠状突骨折后经前内侧手术入路微创内固定治疗的临床效果。方法对2011年9月—2016年10月笔者医院17例尺骨冠状突骨折患者采用肘关节前内侧入路进行手术内固定治疗。按照Regan-Morrey分型,Ⅱ型骨折10例,采用长度合适带线锚钉固定冠状突,再用锚钉的自带线修复关节囊及侧副韧带。Ⅲ型骨折7例,选用1~2枚Herbert螺钉固定冠状突后修复关节囊及副韧带结构。术后随访观察患者的肘关节功能,评分后进行总结分析。结果手术时长25~40min,平均36.7min。本组患者均获得随访6~14个月,平均10.3个月,按Broberg-Morrey评分,17例患者术后优良率93.4%。结论肘关节不稳定的尺骨冠状突骨折手术时采取前内侧入路操作安全可靠,易显露。根据骨块大小选择带线锚钉或者Herbert螺钉固定,手术时间短,创伤小,临床效果满意。

Minimally invasive treatment of ulnar coronary fractures via anteromedial approach

Objective To explore the clinical outcomes of internal fixation of the ulnar coronary fractures via anteromedial approach .Methods Seventeen cases of ulnar coronary fractures were surgically treated via an-temmedial approach from Sept .2011 to Oct.2016.According to Regan-Morrey classification, 10 cases of type Ⅱfractures used cable anchors with appropriate length to fix the coronoid process , and then used the self-repair line of the anchor to repair articular capsule and collateral ligament .7 cases of type Ⅲfracture used 1-2 Herbert screws to fix the coronal process ,and then repaired the joint capsule and accessory ligament structure .After postoperative fol-low-up,the patients'elbow function was observed and the scores were summarized and analyzed .Results The op-eration lasted for 25-40min,with an average of 36.7 min.All cases were followed-up for 6 to 14months(average, 10.3months).According to Broberg-Morrey score,the excellent and good rate was 93.4％.Conclusion The sur-gery of the ulnar coronary fractures via anteromedial approach is safe and reliable and easy to be exposed ,which se-lects the cable anchor or Herbert screw based on the bone block size ,and has advantages of short operation time ,less trauma and satisfactory clinical effect .