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Title: [EFFECTIVENESS OF POSTEROMEDIAL DOUBLE PLATES IN TREATMENT OF COMPLEX OLECRANAL FRACTURE].
Author: Yang R, Zhou Y, Liu L, Cai J, Cao X.
Journal: Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi; 2016 Dec 08; 30(12):1462-1466. PubMed ID: 29786334.
Abstract:
OBJECTIVE: To evaluate the effectiveness of posteromedial double plates in the treatment of complex olecranal fracture. METHODS: Between September 2011 and July 2015, 13 patients with complex olecranal fractures were treated with posterior olecranon locking compression plate and medial mini-plate. There were 8 males and 5 females with an average age of 41.6 years (range, 22-68 years). Injury was caused by traffic accident in 4 cases, falling from height in 6 cases, and crush by object in 3 cases. According to the Mayo classification, fracture was rated as Mayo type ⅡB in 5 cases and as Mayo type ⅢB in 8 cases. Of 13 cases, 7 had Regan-Morrey type Ⅲ coronoid fractures, including 5 anterior dislocations of the elbow joint and 2 posterior dislocations. The time between injury and admission ranged from 1.5 to 10.0 hours (mean, 5.7 hours). At last follow-up, the elbow function was assessed according to the Broberg-Morrey evaluation criteria. X-ray films was performed to observe fracture healing. RESULTS: All incisions healed at first stage and no neural complications occurred. The patients were followed up 9-38 months (mean, 22.1 months). All patients achieved bone union at 3.0-5.5 months (mean, 3.7 months) according to X-ray results. Subluxation of radial head and mild heterotopic ossification occurred in 1 patient respectively, who had no uncomfortable symptoms of movement disorder, elbow instability and pain, and no special management was performed. At last follow-up, the flexion and extension range of motion (ROM) of the elbow was 95-130° (mean, 116.4°); the rotation ROM of the forearm was 150-175° (mean, 170.8°); and the elbow function was excellent in 4 cases, good in 7 cases, and fair in 2 cases, and the excellent and good rate was 84.6%. No internal fixation failure, elbow stiffness, or traumatic arthritis occurred. CONCLUSIONS: For complex olecranal fractures, an early and stable anatomic reconstruction of trochlear notch in the olecranon with posterior olecranon locking compression plate and medial mini-plate can obtain good effectiveness in joint functions. 目的: 探讨后内侧双钢板治疗复杂尺骨鹰嘴骨折的疗效。. 方法: 回顾分析2011年9月-2015年7月采用尺骨鹰嘴解剖钢板联合内侧微型钢板治疗的13例复杂尺骨鹰嘴骨折患者临床资料。男8例，女5例；年龄22～68岁，平均41.6岁。致伤原因：交通事故伤4例，高处坠落伤6例，金属物击伤3例。均为闭合性损伤。骨折根据Mayo分型标准：ⅡB型5例，ⅢB型8例。合并冠状突骨折7例，均为Regan-Morrey Ⅲ型；肘关节前脱位5例，后脱位2例。受伤至入院时间1.5～10.0 h，平均5.7 h。术后X线片复查骨折愈合情况；末次随访时，根据Broberg-Morrey肘关节功能评价标准评定肘关节功能。. 结果: 术后患者切口均Ⅰ期愈合，无尺神经损伤等相关并发症发生。患者均获随访，随访时间9～38个月，平均22.1个月。X线片复查示骨折均愈合，愈合时间3.0～5.5个月，平均3.7个月；发生1例桡骨头半脱位，1例轻度异位骨化，但无肘关节屈伸活动障碍、关节不稳定及疼痛不适症状，未给予特殊处理。末次随访时，肘关节伸屈活动度达95～130°，平均116.4°；旋转活动度为150～175°，平均170.8°；肘关节功能按Broberg-Morrey肘关节功能评价标准，获优4例，良7例，可2例，优良率84.6%。无内固定失败、肘关节僵硬及创伤性骨关节炎等并发症发生。. 结论: 尺骨鹰嘴解剖钢板联合内侧微型钢板可牢固固定骨折、重建滑车切迹，允许术后早期锻炼，治疗复杂尺骨鹰嘴骨折可获得满意疗效。.

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