A Retrospective Study Of Surgical Treatment For Fracture Of The Ulna Coronoid Process

Background:Both biomechanical and clinical studies have demonstrated that the coronoid process is a significant component to the stability of the elbow.The ulna coronoid process is the supporting to stop backward displacement of the ulna,and is also the anterior capsule of elbow joint and anterior bundle of the medial collateral ligament attachment point,the integrity of the coronoid process of the bony structure and surrounding ligaments of the elbow joint stability is important.Such injuries should be treated with surgery.Because of the complexity and particularity of the anatomical location,there is no uniform opinion and scheme for the best operation of coronal fracture.Objective:To retrospectively analyze the clinical curative effect of surgical treatment in China Japan Union Hospital of Jilin University of fractures of the coronoid process,explore options for fractures of the coronoid process of surgical approach,the application of internal fixation,and postoperative rehabilitation of patients.Methods:Select 17 cases of the coronoid process diagnosis and remedy in China Japan Union Hospital of Jilin University fractures from 2014 to 2016.Including these cases,15 cases were male,2 were female;aged 22 to 47 years old,the average age of 33.5;13 cases on the left side,right side in 4 cases;cause of injury: 5 cases of falling injury,tumble in 4 cases,7 cases of traffic accident.The coronoid process fracture block according to the O ’Driscoll type,the corresponding surgical treatment in 17 cases,among them,7 cases of screw fixation and plate fixation 10 cases.Through the anterior approach of elbow joint incision to expose the coronoid process,and the exploration and repair of the medial collateral ligament and joint capsule.All patients were followed up regularly.All patients were followed up for an average of 14.11 months.At the last follow-up,the elbow flexion,extension and pronation and supination were observed and measured by MAYO(Mayo elbow performance score)elbow joint function scoring system was used to evaluate the recovery of elbow function.Result:In this retrospective study of all patients were followed up for 8~23 months,the average time is 14.1 months,follow-up of patients with wounds were healed without infection,postoperative fractures are healing,the average healing time of 12 weeks,patients according to Mayo score evaluation,9 cases were excellent,8 cases good,0 cases,poor in 0 cases.According to the data,the activity range of type I,type II and type III elbow joint was compared with that of the healthy side,and x± s was used.The paired t test between groups was used to calculate the P value,and the significant standard was P > 0.05.Table of elbow joint activity.The average MEPS score was 92.5 points,and all the patients recovered well.Conclusion:Through a retrospective analysis of 17 cases of patients in China Japan Union Hospital of Jilin University,and the literatures at home and abroad,we can draw the following conclusions: 1.Most patients required surgical treatment of coronoid fracture,recovery of elbow joint and lateral anatomical structure to repair the damage to the deputy ligament.It is helpful for the recovery of elbow joint function after operation,which is reasonable and effective.2.In the surgical treatment of coronal fractures,the anterior medial approach of the elbow has the advantages of sufficient exposure,high safety factor,less damage,and is beneficial to the recovery of the function of the elbow joint.