冠突骨折及合并桡骨小头粉碎骨折生物力学

目的]分析尺骨冠突骨折及合并桡骨小头粉碎骨折时肘关节的稳定性。方法]选取上肢尸体标本8对，测试各种冠突骨折及合并桡骨小头粉碎骨折时肘外翻位移及外旋角。结果]肘关节稳定性在冠突无骨折、Ⅰ型骨折、Ⅱ型骨折各组间无显著差异，冠突Ⅲ型骨折时显著不稳定。结论]冠突骨折及合并桡骨小头粉碎骨折在冠突Ⅰ型、Ⅱ型骨折时肘关节稳定，可行桡骨小头切除术，Ⅲ型骨折不稳定，应修复桡骨小头或假体置换，并修复桡侧副韧带。

Biomechanical analysis on the coronoid process fracture merging radial head comminuted fracture

Objective] To determine the elbow joint stability in the coronoid process fracture and the coronoid process fracture merging radial head comminuted fracture by a mechanical experimental analysis.Method]Eight pairs of upper limbs of embalmed anatomic specimens were selected, the eversion displacements and the external rotation angles in different coronoid process fractures and coronoid process fractures merging radial head comminuted fractures were measured. The differences between them were recorded.Result] No significant difference was found among the non-fracture, the type I fracture and the type II fracture, but the elbow eversion displacement in the type III fracture significantly increased.Conclusion] According to the result of the experiment, the elbow eversion and external rotation are stable under the condition of the coronoid process fracture merging the radial head comminuted fracture in the type I and the type II fractures, thus the radial head excision can be performed safely. By contrast, it is unstable in the type III fracture, extra operation should be taken to repair the radial head or make the prosthetic replacement while repairing the ligamentum collaterale radiale at the same time.