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A novel anterior approach for the fixation of ulnar coronoid process fractures.

Abstract：

BACKGROUND:There is no universally accepted approach to the elbow for the fixation of coronoid process fractures. This study aims to introduce a novel anterior surgical approach for the fixation of the ulnar coronoid fracture, with minimal surgical dissection damage and excellent visualization for reduction and internal fixation. HYPOTHESIS:The anterior approach can facilitate satisfactory outcomes for coronoid process fractures. MATERIAL AND METHODS:From February 2010 to July 2014, 12 patients (8 males and 4 females; range 14-62years; mean age 31years) with a closed fracture of the coronoid process of the ulna were included in this study. According to Adams classification, we included 5 type II, 3 type III, 3 type IV AM, and 1 type IV AL. The fractures were treated operatively via an anterior approach between nerves and blood vessels. The anatomical reduction and fixation with cannulated screws or a mini plate was easily performed. One elbow showed significant joint instability, necessitating, another incision to repair the lateral collateral ligament, and a subsequent operation with a hinged external fixator was required. The remaining patients received a splint for 2 weeks followed by functional exercises. RESULTS:Mean follow-up was 21 months (13-36). Fracture union was achieved in each patient. The arc of elbow flexion and extension were (135±15)°, and forearm pronation/supination were restored to (165±15)°. When compared with the normal side, there was no significant difference in the functional outcome (P>0.05). According to Morrey' scale, the functional recovery of the injured arms was assessed as excellent in eleven patients and good in one. Mild heterotopic ossification was found in one case, which had not impaired the elbow function. No other complications were noted. CONCLUSIONS:The anterior approach has the benefits of simplicity, safety, minimal invasion, excellent exposure, and satisfactory prognosis for coronoid process fractures. LEVEL OF EVIDENCE:Prospective study, Level IV.

journal_name

Orthop Traumatol Surg Res

journal_title

Orthopaedics & traumatology, surgery & research : OTSR

authors

Yang X,Chang W,Chen W,Liu S,Zhu Y,Zhang Y

doi

10.1016/j.otsr.2017.05.020

subject

Has Abstract

pub_date

2017-10-01 00:00:00

pages

899-904

issue

issn

1877-0568

pii

S1877-0568(17)30179-2

journal_volume

103

pub_type

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A novel anterior approach for the fixation of ulnar coronoid process fractures.