| Objective: To observe the clinical effect of loop plate in the treatment of ulna coronary process fracture in the triple joint of elbow joint terror,and to compare the clinical effect of the single lateral approach and the internal and external joint approach for the repair of the patients.Methods 70 cases of elbow joint terror triple syndrome were analyzed retrospectively from January 2015 to December 2019 in trauma orthopaedics department of Xi’an Honghui hospital.According to the operation approach,38 cases were divided into single lateral approach group(group A)and 32 cases in internal and external combined approach group(group B).The results of the operation were evaluated by the elbow joint activity and MEPs score.The results were compared with the two groups.The perioperative data of the two groups were compared,including the bleeding,hospitalization time and VAS score.According to the X-ray films and the examination of the normal side position of the patients in 3 months,6 months and 1 year after operation,the fracture healing,internal fixation failure,ectopic ossification,elbow stiffness and ulnar were evaluated and compared The complications of neurosymptoms,incision infection and so on;Results there was no significant difference in the general data between the two groups(P >0.05).There was no significant difference in the amount of bleeding,hospitalization time,VAS score and bone healing time between the two groups(P > 0.05).In the O’Driscoll type I coronary process fracture,the operation time of group A was lower than that of group B,and the difference between the two groups was statistically significant(P < 0.05).In O’Driscoll Ⅱtype coronary process fracture,there was no statistical significance between the two groups(P > 0.05);The flexion of elbow joint activity in group A was(123.45 ± 6.38)° and straightening(8.21 ± 2.69)° and pre rotation(80.43 ± 3.45)° and post rotation(86.32 ±3.11)° respectively,which were better than those of group B(115.12 ± 12.16)° and straightening(12.23 ± 8.03)° before rotation(71.56 ± 6.83)° and post rotation(73.18 ±5.16)° respectively.The difference between the two groups was statistically significant(P <0.001)(see Table 3).The total score of MEPs in group A was(87.62 ± 2.21),higher than that of group B(84.33 ± 4.52),among which group A was higher than group B in terms of motor function and daily life score,and the difference between the two groups was statistically significant(P < 0.001).There was no statistical significance between the two groups in pain and stability score(P > 0.05),and the difference was not statistically significant between the two groups(P > 0.05).38 patients in group A,21 were excellent,13 were good,2 were OK,2were poor,and the excellent rate was 89%;32 patients in group B were excellent,18 were excellent,7 were good,5 were OK,2 were poor,and the excellent rate was 81%.There was no statistical difference between the two groups(P > 0.05).No fracture union and ulnar nerve symptoms were found in both groups.One patient in group A was reexamined with X-ray plate displacement 3 months after operation,but the coronary process bone healed well without any special treatment;one patient in group A and two patients in group B had superficial incision infection,which healed after drug exchange;there was no significant difference in internal fixation failure,fracture nonunion,stiff elbow joint and superficial infection complications(P > 0.05).According to Hastings Graham ectopic ossification classification,one case was type I and one in type III in group A,one in group B,2 in type II and 4 in type III.The difference between the two groups was statistically significant(P <0.05).Conclusion: The treatment of elbow joint terror triple syndrome with single lateral approach and loop plate fixation can achieve better elbow function prognosis and lower incidence of ectopic ossification compared with the internal and external joint approach;for some anterior and medial coronary fractures,it is difficult to get enough exposure and operation space through the single lateral approach to complete the bone channel recommendations and loop plate Fixation,which leads to the prolongation of operation time and the change of operation plan,is more suitable for the internal and external joint approach;... |
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