尺骨冠状突骨折合并桡骨小头粉碎骨折时肘关节稳定性研究

目的：用实验方法分析尺骨冠状突骨折合并桡骨小头粉碎骨折时肘关节稳定性。方法：选取上肢尸体标本8对,用生物力学机测试各种冠状突骨折合并桡骨小头粉碎骨折时肘关节外翻位移及外旋转角。结果：肘关节稳定性在冠状突无骨折、Ⅰ型骨折、Ⅱ型骨折,各组间无显著差异,冠状突Ⅲ型骨折时显著增大。结论：冠状突骨折合并桡骨小头粉碎骨折在冠状突Ⅰ型、Ⅱ型骨折时肘关节是稳定的,可行桡骨小头切除术,Ⅲ型骨折时不稳定,应修复桡骨小头或行假体置换,并同时修复桡侧副韧带。

Biomechanical Analysis of Coronoid Process Fracture merging Radial Head Comminuted Fracture

Objective： To analyze the stability of elbow joint in each type of coronoid process fracture merging radial head comminuted fracture using biomechanics.Methods： Eight pairs of upper limbs from embalmed anatomic specimens were selected.The eversion displacements and external rotation angles in different coronoid process fractures merging radial head comminuted fracture were measured and compared.Results： There were no significant differences in elbow joint stability among non-fracture,type Ⅰand type Ⅱfractures of coronoid process,but the elbow eversion displacement in type Ⅲ fracture significantly increased.Conclusion： The elbow eversion and external rotation are stable in typeⅠ and type Ⅱ fractures of coronoid process merging radial head comminuted fracture,thus radial head excision can be performed safely.Whereas in type Ⅲ fracture,extra operation should be taken to repair the radial head or make the prosthetic replacement and repair the ligamentum collaterale radiale at the same time.