A Retrospective Analysis Of The Elbow Injury Ulna Coronoid Fractures

Objective In this paper, it takes the O’Driscoll classification as the basis of the ulna coracoid process fractures, the treatment to ulna coronoid process fractures and recovery condition of late elbow joint function are explored so as to provide a reasonable suggestion for the clinical treatment to ulna coronoid process fractures.Methods To make a retrospective analysis of the clinical treatment to a total of 19 cases of patients with the ulna coronoid process fracture in the Second Hospital of Tangshan City from 2010 January to 2014 January. All patients have completed the inspect of elbow joint and adem position X-ray films and CT three-dimensional reconstruction. They are classified according to O’Driscoll: 2 cases belong to I type, and all of them are Ia type. 10 cases belong to type II, including 1 case of II a type, 4 cases of II b type, 5 cases of II c type. 7 cases belong type III, including 4 cases of III a type, 3 cases of III b type. Combined injury: 4 cases of simple type of ulna coronoid process fractures, 5 cases of the combined radial head fractures, 3 cases of olecranal fracture, 2 cases of posterior dislocation of the elbow and fracture of head of radius, 1 case of fracture of neck of radius, 2 cases of internal condyle of humerus and humeral lateral condyle fracture, respectively. 17 cases have been surgical treatment, whereby 1 case of bone piece removal, 6 cases of screw fixation, 4 cases of Kirschner wire fixation, 1 case of Kirschner wire silk suture fixation, 5 cases of bone fracture plate fixation. In addition, 2 cases of plaster fixation about conservative treatment.Result 19 cases of patients with ulna coronoid process fractures has achieved follow-up, of which time is from 8 to 74 months, and the average follow-up time was 16 months, elbow X-ray film reveals that ulna coronoid process fractures are healed at one-stage period. The average healing time was 10 weeks. According to the functional score of Merry elbow joint, 7 cases were excellent, 8 cases were good, 2 cases were approved, 2 cases were poor, the satisfaction rate was 78.9%. In this group, it includes 1 case of heterotopic ossification, 1 case of ulnar nerve palsy, but paralysis symptoms disappeared in 3 months, 1 case of traumatic arthritis. All the patients had no infection, internal fixation loosening and prolapse and ankylosis or other complications.Conclusion 1 O’Driscoll typing method is important for the treatment of ulna coracoid process fracture. 2 Expectant treatments are effective enough for the recovery of typeⅠulna coracoid process fracture, but operations, such as repairing the lateral collateral ligament and removing the pieces of bone, are essential for patients who have elbow instability or bone embeddedness. 3 Operations show good effects on O’Driscoll Ⅱtype and Ⅲ type of ulna coracoid process fracture, the processes of which are as follows: Select appropriate internal fixation method according to the severity of the bone comminution, repair the lateral collateral ligament and joint capsule so that the stability of elbow joint will be recovered.