| Objective: Comparative analysis the clinical effect of Gram + wire fence type needle fixation internal fixation and hollow screw internal fixation on the treatment of Morrey type ? fracture of ulna coronoid process.Methods: We collected 21 cases clinical data of Morrey type ? fracture of ulna coronoid process that treated in the first orthopedics department of Jiangxi People's Hospital from March 2013 to May 2016.On the basis of clear diagnostic criteria and strict inclusion and exclusion criteria,we choose 18 cases and retrospectively analyzed their relevant information including medical records,images,surgical operation and postoperative follow-up records.These patients were divided into two groups according to the method of internal fixation: group A were treated with hollow screw internal fixation(5 males and 3 females,18-53 years of age,mean age: 36.31,6 cases on the left and 2 cases on the right,causes of injury: 3 cases in the fall down injury,3 cases in the traffic injury and 2 cases in the high falling injury);group B were treated with Gram + wire fence type needle fixation internal fixation(6 males and 4 females,20-45 years of age,3 cases on the left and 7 cases on the right,causes of injury: 2 cases in the fall down injury,5 cases in the traffic injury and 3 cases in the high falling injury,in which 4 cases complicated with elbow joint dislocation and other intra-articular fractures).Comparative analysis the surgical operation time,postoperative healing time,visual analogue scale(VAS),Broberg and Morrey elbow score,elbow joint activity and postoperative complications between two groups.Results: All patients of two groups were followed up for 6-12 months with an average of 10.21 ± 2.02 months,and their incisions were healing by first intension with no damage to vascular and nervous as well as no infection in the incisions.The surgical operation time and intraoperative hemorrhages were significantly lower in group B compared with group A(P < 0.05),and the healing time of postoperative fracture between the two groups was also statistically significant(P < 0.05).By observing the degree of pain relief,we found group B was obviously better than group A at 3 days,1 week and 2 weeks after operation(P < 0.05).Comparing the elbow function score between two groups,group B was higher than group A at 1 month and 3 months after operation(P < 0.05),while there was no differences at 6 months and 12 months after operation(P > 0.05).In addition,at 12 months after operation,although the excellent rate of elbow function of group B(90%)looks higher than group A(87.5%),but there was no statistically significant(P > 0.05),whereas the elbow joint activity of group B was significantly superior to group A(P < 0.05).All patients of two groups had no infection,ulnar nerve injury,fracture nonunion,elbow instability and other complications occurred,and there was no rejections after implanting hollow screw and Kirschner wire.X-ray examination revealed that 1 case in each of the two groups had mild heterotopic ossification at 1 month after operation.Moreover,the follow-up survey at 12 months after operation showed that 1 case in each of the two groups had mild pain during elbow joint activities.Conclusion: Hollow screw internal fixation and Gram + wire fence type needle fixation internal fixation are two commendable internal fixation methods to treat Morrey type ? fracture of ulna coronoid process.In this study,compared the clinical efficacy of these two methods,Gram + wire fence type needle fixation internal fixation has many advantages including short operation time,stable fixation,well activity of elbow joint and early recovery of elbow function,cost of cheapness,and has the innovative,which can act as a novel choice for treatment of Morrey type ? fracture of ulna coronoid process. |
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