Surgical Treatment for Complicated Proximal Ulnar Fracture_West China Medical Journal

Authors：

 ZhangBin , ChenLijiang , LiChangkun , YangXianwu

Department of Orthopedics, People's Hospital of Jiangyou, Jiangyou, Sichuan 621700, P. R. China;

Corresponding?author：

Keywords：

Ulna; Fracture; Surgical therapy

DOI：

10.7507/1002-0179.201600130

Video：

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Objective To explore the surgical method and its clinical efficacy for complicated proximal ulnar fracture. Methods From February 2006 to July 2014, 22 patients with complicated proximal ulnar fracture were treated by open reduction with internal fixation. There were 17 males and 5 females with an average age of 32 years. According to AO classification, there were 4 cases of type C1, 13 of type C2, and 5 of type C3. Among the, there were 4 cases combined with posterior elbow dislocation, 2 cases combined with anterior elbow dislocation, and there were 2 Monteggia Ⅳ cases. Nineteen cases were close fractures, and the other 3 were open fractures. Nerve and vessel injury was not found in all cases. The time before operation was 7 to 12 days, with an average of 8 days. All patients were treated with open reduction and internal fixation. Mayo standard for evaluation of elbow joint was used to evaluate the therapeutic effect after operation. Results All the patients were followed up from 8 to 18 months, with an average of 14 months. All fractures were completely healed. The healing time ranged from 12 to 30 weeks averaging 16 weeks. No failure of internal fixation occurred; no elbow anchyloses or instability occurred. The range of motion of elbow joint was between 120° and 140°, with an average of 135°. Mayo elbow score showed that 16 cases were excellent, 4 good, and 2 fair with an excellent and good rate of 90.9%. Conclusion Early surgical treatment and rehabilitative training can facilitate satisfactory effects on complicated proximal ulnar fracture.

Citation： ZhangBin, ChenLijiang, LiChangkun, YangXianwu. Surgical Treatment for Complicated Proximal Ulnar Fracture. West China Medical Journal, 2016, 31(3): 491-494. doi: 10.7507/1002-0179.201600130 Copy

1.	王友華, 湯錦波, 周學軍, 等. 尺骨冠突骨折對肘關節穩定性的影響[J]. 中華骨科雜志, 2005, 25(3):155-158.
2.	楊運平, 徐達傳, 趙衛東, 等. 肘關節穩定性的應用解剖和生物力學研究[J]. 中國臨床解剖學雜志, 2002, 20(4):243-245.
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5.	Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid[J]. J Bone Joint Surg Am, 2002, 84(4):547-551.
6.	Heim U. Kombinierte vefletzungen von radius and ulnar im proximalen unteram segment[J]. Hefte Unfallechir, 1994(241):61-79.
7.	李武, 趙友明, 陶正剛, 等. 橈骨小頭骨折與前臂骨間膜損傷的相關性研究[J]. 中華骨科雜志, 2012, 32(7):664-668.
8.	張貴林, 伊明江, 李楠, 等. 尺骨鷹嘴粉碎性骨折短縮固定后的肘關節功能研究[J]. 中華骨科雜志, 2003, 23(10):627-630.
9.	Mezera K, Rockwood CA Jr. Fractures in adults[M]. 5th ed. Philadelphia:Lippincott Wikins, 200l:935-939.
10.	王世龍, 湯超亮, 張權, 等. 角穩定鋼板結合關節面下支撐治療關節面粉碎的尺骨鷹嘴骨折[J]. 中華骨科雜志, 2014, 34(10):1008-1015.
11.	Zuelzer WA. Fixation of small but important bone fragments with a hook plate[J]. J Bone Joint Surg Am, 1951, 33(2):430-436.
12.	陳士鶴, 薛偉, 張學峰, 等. 微創鋼板固定技術治療肱骨干中下段骨折的療效觀察[J]. 黑龍江醫學, 2010, 34(1):35-37.
13.	朱晨, 孔榮, 張先龍. 肘關節"恐怖三聯征"的理論基礎與研究進展[J]. 中華關節外科雜志:電子版, 2014, 8(3):383-387.
14.	張世民, 俞光榮, 袁鋒, 等. 肘關節后脫位伴橈骨頭和尺骨冠突骨折(恐怖三聯征)5例初步報告[J]. 中國矯形外科雜志, 2007, 15(14):1069-1073.
15.	Ring D. Fractures of the coronoid process of the ulna[J]. J Hand Surg Am, 2006, 31(10):1679-1689.
16.	張弛, 仲飆, 羅從風, 等. 外側入路聯合前內側入路治療肘關節"恐怖三聯征"的手術療效[J]. 中華骨科雜志, 2015, 35(4):320-327.
17.	王兮, 梁炳生. 尺骨冠突骨折分型及治療進展[J]. 國際骨科學雜志, 2008, 29(5):304-306.
18.	蔣協遠, 李庭, 張力丹, 等. 人工橈骨頭置換治療肘關節不穩定的橈骨頭粉碎性骨折[J]. 中華骨科雜志, 2005, 25(8):467-471.
19.	Schatzker J, Tile M. 骨折手術治療原理[M]. 彭阿欽, 譯. 3版. 北京:人民衛生出版社, 2007:90-123.
20.	嚴明明, 宋德業, 丁木亮, 等. 人工橈骨頭置換治在肘關節恐怖三聯征中的應用[J]. 中華骨科雜志, 2014, 34(6):652-658.
21.	李庭, 王滿宜, 蔣協遠, 等. 肘關節"恐怖三聯征"的診斷與治療[J]. 中華骨科雜志, 2009, 29(5):398-403.
22.	Lindenhovius AL, Jupiter JB, Ring D. Comparison of acute versus subacute treatment of terrible triad injuries of the elbow[J]. J Hand Surg Am, 2008, 33(6):920-926.
23.	王友華, 劉璠, 周振宇, 等. 尺骨近端粉碎性骨折伴肘關節不穩定的治療[J]. 中華骨科雜志, 2008, 28(4):283-287.

1. 王友華, 湯錦波, 周學軍, 等. 尺骨冠突骨折對肘關節穩定性的影響[J]. 中華骨科雜志, 2005, 25(3):155-158.
2. 楊運平, 徐達傳, 趙衛東, 等. 肘關節穩定性的應用解剖和生物力學研究[J]. 中國臨床解剖學雜志, 2002, 20(4):243-245.
3. Müller ME, Allg ?wer M, Schneider R, et al. 骨科內固定[M]. 3版. 榮國威, 翟桂華, 劉沂, 等, 譯. 北京:人民衛生出版社, 1995:81-111.
4. 胥少汀, 葛寶豐, 徐印坎. 實用骨科學[M]. 3版. 北京:人民軍醫出版社, 2005:730-747.
5. Ring D, Jupiter JB, Zilberfarb J. Posterior dislocation of the elbow with fractures of the radial head and coronoid[J]. J Bone Joint Surg Am, 2002, 84(4):547-551.
6. Heim U. Kombinierte vefletzungen von radius and ulnar im proximalen unteram segment[J]. Hefte Unfallechir, 1994(241):61-79.
7. 李武, 趙友明, 陶正剛, 等. 橈骨小頭骨折與前臂骨間膜損傷的相關性研究[J]. 中華骨科雜志, 2012, 32(7):664-668.
8. 張貴林, 伊明江, 李楠, 等. 尺骨鷹嘴粉碎性骨折短縮固定后的肘關節功能研究[J]. 中華骨科雜志, 2003, 23(10):627-630.
9. Mezera K, Rockwood CA Jr. Fractures in adults[M]. 5th ed. Philadelphia:Lippincott Wikins, 200l:935-939.
10. 王世龍, 湯超亮, 張權, 等. 角穩定鋼板結合關節面下支撐治療關節面粉碎的尺骨鷹嘴骨折[J]. 中華骨科雜志, 2014, 34(10):1008-1015.
11. Zuelzer WA. Fixation of small but important bone fragments with a hook plate[J]. J Bone Joint Surg Am, 1951, 33(2):430-436.
12. 陳士鶴, 薛偉, 張學峰, 等. 微創鋼板固定技術治療肱骨干中下段骨折的療效觀察[J]. 黑龍江醫學, 2010, 34(1):35-37.
13. 朱晨, 孔榮, 張先龍. 肘關節"恐怖三聯征"的理論基礎與研究進展[J]. 中華關節外科雜志:電子版, 2014, 8(3):383-387.
14. 張世民, 俞光榮, 袁鋒, 等. 肘關節后脫位伴橈骨頭和尺骨冠突骨折(恐怖三聯征)5例初步報告[J]. 中國矯形外科雜志, 2007, 15(14):1069-1073.
15. Ring D. Fractures of the coronoid process of the ulna[J]. J Hand Surg Am, 2006, 31(10):1679-1689.
16. 張弛, 仲飆, 羅從風, 等. 外側入路聯合前內側入路治療肘關節"恐怖三聯征"的手術療效[J]. 中華骨科雜志, 2015, 35(4):320-327.
17. 王兮, 梁炳生. 尺骨冠突骨折分型及治療進展[J]. 國際骨科學雜志, 2008, 29(5):304-306.
18. 蔣協遠, 李庭, 張力丹, 等. 人工橈骨頭置換治療肘關節不穩定的橈骨頭粉碎性骨折[J]. 中華骨科雜志, 2005, 25(8):467-471.
19. Schatzker J, Tile M. 骨折手術治療原理[M]. 彭阿欽, 譯. 3版. 北京:人民衛生出版社, 2007:90-123.
20. 嚴明明, 宋德業, 丁木亮, 等. 人工橈骨頭置換治在肘關節恐怖三聯征中的應用[J]. 中華骨科雜志, 2014, 34(6):652-658.
21. 李庭, 王滿宜, 蔣協遠, 等. 肘關節"恐怖三聯征"的診斷與治療[J]. 中華骨科雜志, 2009, 29(5):398-403.
22. Lindenhovius AL, Jupiter JB, Ring D. Comparison of acute versus subacute treatment of terrible triad injuries of the elbow[J]. J Hand Surg Am, 2008, 33(6):920-926.
23. 王友華, 劉璠, 周振宇, 等. 尺骨近端粉碎性骨折伴肘關節不穩定的治療[J]. 中華骨科雜志, 2008, 28(4):283-287.

West China Medical Journal

Surgical Treatment for Complicated Proximal Ulnar Fracture

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