Herbert螺钉治疗尺骨冠状突骨折临床体会
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摘要
目的回顾分析Herbert螺钉治疗38例尺骨冠状突骨折的手术过程及预后,加深对尺骨冠状突骨折概念的认识,并报告临床治疗体会。方法 2011年10月～2017年12月收住入院的尺骨冠状突骨折患者共38例。尺骨冠状突骨折按Regan-Morrey分型Ⅱ型28例,Ⅲ型10例。38例均行手术治疗,运用3.0 mm Herbert螺钉固定尺骨冠状突骨折。结果 38例患者均获随访,随访时间4月～6年,骨折均愈合,关节稳定,均未发生骨化性肌炎,5例活动后有轻微疼痛。根据Mayo肘关节功能评分:优14例(>90分),良17例(89-75分),中6例(74-60分),差1例(<60分),优良率81.57%。结论采用Herbert螺钉治疗尺骨冠状突骨折具有固定牢靠,不影响关节活动,无需二次取出,能够早期功能锻炼等优点,术后疗效满意。
Objective Retrospective analysis of Herbert screw treatment of ulnar coronoid process fractures in the surgical process and prognosis, deepen the understanding of the concept of ulna coronoid process fractures, and report clinical treatment experience.Methods From October 2011 to December 2017, there were 38 cases of ulna coronoid fractures. Fracture of ulna coronoid process according to Regan-Morrey type II in 28 cases, type III in 10 case. All 38 cases underwent surgical treatment and a 3.0 mm Herbert screw was used to fix the fracture of the ulnar coronoid process. Results All 38 patients were followed up for 4 months to 6 years.The fractures healed and the joints were stable. No myositis ossificans occurred. 5 patients had slight pain after the activity. According to Mayo's elbow function scores: excellent in 14 cases(>90 points), good in 17 cases(89-75 points), moderate 6 cases(74-60 points),poor in 1 cases(<60 points), excellent rate of 81.58%. Conclusion The use of Herbert screw in the treatment of ulnar coronoid process fracture is fixed and reliable, It do not affect the joint activity, no secondary removal, can early functional exercise and the postoperative effect is satisfactory.
Objective Retrospective analysis of Herbert screw treatment of ulnar coronoid process fractures in the surgical process and prognosis, deepen the understanding of the concept of ulna coronoid process fractures, and report clinical treatment experience.Methods From October 2011 to December 2017, there were 38 cases of ulna coronoid fractures. Fracture of ulna coronoid process according to Regan-Morrey type II in 28 cases, type III in 10 case. All 38 cases underwent surgical treatment and a 3.0 mm Herbert screw was used to fix the fracture of the ulnar coronoid process. Results All 38 patients were followed up for 4 months to 6 years.The fractures healed and the joints were stable. No myositis ossificans occurred. 5 patients had slight pain after the activity. According to Mayo's elbow function scores: excellent in 14 cases(>90 points), good in 17 cases(89-75 points), moderate 6 cases(74-60 points),poor in 1 cases(<60 points), excellent rate of 81.58%. Conclusion The use of Herbert screw in the treatment of ulnar coronoid process fracture is fixed and reliable, It do not affect the joint activity, no secondary removal, can early functional exercise and the postoperative effect is satisfactory.
引文
[1]Regan W,Morrey B.Fractures of the coronoid process of the ulna[J].Journal of Bone&Joint Surgery American Volume,1989,71(9):1348.
[2]Heim U,Buhler M.Kombinierte Verletzungen von Radius und Ulna im proximalen Unterarmsegmentglllent[J].Hefte zu der Unfallchirurg,1994,241:61-80.
[3]赵王林,杨海韵,吴征杰.金属铰链外固定支架与有限针钉置入内固定治疗肘关节“恐怖三联征”[J].中国组织工程研究与临床康复,2011,(17):3206-3211.
[4]Fern S E,Owen J R,Ordyna N J,et al.Complex varus elbow instability:a terrible triad model[J].Journal of Shoulder and Elbow Surgery,2009,18(2):269-274.
[5]李高舜,林晓,黄志明.内外侧入路手术治疗肘关节恐怖三联征[J].中国骨与关节损伤杂志,2012,27(1):67-68.
[6]陈辉东,马军,谢飞彬,等.肘关节内侧入路Herbert钉内固定治疗尺骨冠状突骨折[J].中国骨与关节损伤杂志,2015,30(7):774-775.
[7]杨健,陈建国.尺骨冠状突骨折的研究进展[J].河北联合大学学报:医学版.2014,(1):29-31.
[8]文宏为,刘芬.不同内固定术入路方式治疗尺骨冠状突骨折临床效果比较[J].海南医学,2016,(11):1802-1805.
[9]朱贤久,朱仪,杜中兴,等.肘前“S”形切口切开复位钢丝张力带内固定治疗尺骨冠状突骨折13例体会[J].中国卫生产业,2012,(1):121.
[10]韩志强,狄东华,陈永华,等.Herbert螺钉在骨科临床中应用50例分析[J].中国煤炭工业医学杂志,2012,(10):1487-1489.
[11]胡维帆,黄强,邹守平,等.带线锚钉在尺骨冠状突骨折治疗中的应用体会[J].实用骨科杂志,2013,(6):546-547.
[2]Heim U,Buhler M.Kombinierte Verletzungen von Radius und Ulna im proximalen Unterarmsegmentglllent[J].Hefte zu der Unfallchirurg,1994,241:61-80.
[3]赵王林,杨海韵,吴征杰.金属铰链外固定支架与有限针钉置入内固定治疗肘关节“恐怖三联征”[J].中国组织工程研究与临床康复,2011,(17):3206-3211.
[4]Fern S E,Owen J R,Ordyna N J,et al.Complex varus elbow instability:a terrible triad model[J].Journal of Shoulder and Elbow Surgery,2009,18(2):269-274.
[5]李高舜,林晓,黄志明.内外侧入路手术治疗肘关节恐怖三联征[J].中国骨与关节损伤杂志,2012,27(1):67-68.
[6]陈辉东,马军,谢飞彬,等.肘关节内侧入路Herbert钉内固定治疗尺骨冠状突骨折[J].中国骨与关节损伤杂志,2015,30(7):774-775.
[7]杨健,陈建国.尺骨冠状突骨折的研究进展[J].河北联合大学学报:医学版.2014,(1):29-31.
[8]文宏为,刘芬.不同内固定术入路方式治疗尺骨冠状突骨折临床效果比较[J].海南医学,2016,(11):1802-1805.
[9]朱贤久,朱仪,杜中兴,等.肘前“S”形切口切开复位钢丝张力带内固定治疗尺骨冠状突骨折13例体会[J].中国卫生产业,2012,(1):121.
[10]韩志强,狄东华,陈永华,等.Herbert螺钉在骨科临床中应用50例分析[J].中国煤炭工业医学杂志,2012,(10):1487-1489.
[11]胡维帆,黄强,邹守平,等.带线锚钉在尺骨冠状突骨折治疗中的应用体会[J].实用骨科杂志,2013,(6):546-547.
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