袢钢板技术治疗肘关节恐怖三联征的临床研究

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Abstract Objective To investigate the surgical strategies of loop-plate technique for the fracture of ulnar coronoid process，and its application value and clinical effecacy in the terrible triad of the elbow joint.Methods A retrospective study was conducted on 33 patients who had been treated for terrible triad of the elbow joint from January 2013 to June 2016.They were 21 males and 12 females，26 to 68 years (mean，38.6 years).Injury Causes included fall injury in 21 cases，high-falling injury in 7 cases，traffic injury in 5 cases.All the patients underwent surgical treatments，and performed to repair the fracture of ulnar coronoid process，the fracture of radial head，and the lateral collateral ligamentous complex from the deep layer to superficial layer in turn.All the fracture of ulnar coronoid process were treated with loop-plate technique，the fracture of radial head was fixed with tiny-plate，anatomical plate and hollow screws or replaced with the prosthesis，and the lateral collateral ligamentous complex was reconstructed with suture anchor without the surgical repair of the medial collateral ligamentous complex.All the patients were equipped with an adjustable brace postoperatively and performed the early function rehabilitation of elbow joint.Results 33 patients were followed up for 18 to 24 months with a mean of 20.2 months.All patients got the healing of bony and ligamentous structures.MEPS score of the last follow-up was 55 to 100 with the average of 85.8.The elbow function was excellent in 19 cases，good in 8，fair in 3 and poor in 3.The rate of excellent and good was 81.8％.Elbow stiffness occurred in 2 cases，heterotopic ossification occurred in 3 cases and superficial infection occurred in 1 case and cured by anti-infection and wound care.No other severe complications like neurovascular injury，loosening or breakage of internal implants，dislocation of elbow joint，fracture nonunion and deep infection occurred.Conclusion The restoration of the fracture of ulnar coronoid process is the key factor.The loop-plate technique for the fracture of ulnar coronoid process in the treatment for the terrible triad of the elbow can obtain an excellent fixation of coronoid process，restore the elbow joint stability，early functional exercise，and obtain the satisfactory clinical effects.

Key words： ulna coronoid process fracture elbow joint internal fixation

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