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.	王友华, 汤锦波, 周学军, 等. 尺骨冠突骨折对肘关节稳定性的影响[J]. 中华骨科杂志, 2005, 25(3):155-158.
2.	杨运平, 徐达传, 赵卫东, 等. 肘关节稳定性的应用解剖和生物力学研究[J]. 中国临床解剖学杂志, 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, 赵友明, 陶正刚, 等. 桡骨小头骨折与前臂骨间膜损伤的相关性研究[J]. 中华骨科杂志, 2012, 32(7):664-668.
8.	张贵林, 伊明江, 李楠, 等. 尺骨鹰嘴粉碎性骨折短缩固定后的肘关节功能研究[J]. 中华骨科杂志, 2003, 23(10):627-630.
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10.	王世龙, 汤超亮, 张权, 等. 角稳定钢板结合关节面下支撑治疗关节面粉碎的尺骨鹰嘴骨折[J]. 中华骨科杂志, 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.	陈士鹤, 薛伟, 张学峰, 等. 微创钢板固定技术治疗肱骨干中下段骨折的疗效观察[J]. 黑龙江医学, 2010, 34(1):35-37.
13.	朱晨, 孔荣, 张先龙. 肘关节"恐怖三联征"的理论基础与研究进展[J]. 中华关节外科杂志:电子版, 2014, 8(3):383-387.
14.	张世民, 俞光荣, 袁锋, 等. 肘关节后脱位伴桡骨头和尺骨冠突骨折(恐怖三联征)5例初步报告[J]. 中国矫形外科杂志, 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.	张弛, 仲飙, 罗从风, 等. 外侧入路联合前内侧入路治疗肘关节"恐怖三联征"的手术疗效[J]. 中华骨科杂志, 2015, 35(4):320-327.
17.	王兮, 梁炳生. 尺骨冠突骨折分型及治疗进展[J]. 国际骨科学杂志, 2008, 29(5):304-306.
18.	蒋协远, 李庭, 张力丹, 等. 人工桡骨头置换治疗肘关节不稳定的桡骨头粉碎性骨折[J]. 中华骨科杂志, 2005, 25(8):467-471.
19.	Schatzker J, Tile M. 骨折手术治疗原理[M]. 彭阿钦, 译. 3版. 北京:人民卫生出版社, 2007:90-123.
20.	严明明, 宋德业, 丁木亮, 等. 人工桡骨头置换治在肘关节恐怖三联征中的应用[J]. 中华骨科杂志, 2014, 34(6):652-658.
21.	李庭, 王满宜, 蒋协远, 等. 肘关节"恐怖三联征"的诊断与治疗[J]. 中华骨科杂志, 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.	王友华, 刘璠, 周振宇, 等. 尺骨近端粉碎性骨折伴肘关节不稳定的治疗[J]. 中华骨科杂志, 2008, 28(4):283-287.

1. 王友华, 汤锦波, 周学军, 等. 尺骨冠突骨折对肘关节稳定性的影响[J]. 中华骨科杂志, 2005, 25(3):155-158.
2. 杨运平, 徐达传, 赵卫东, 等. 肘关节稳定性的应用解剖和生物力学研究[J]. 中国临床解剖学杂志, 2002, 20(4):243-245.
3. Müller ME, Allg öwer M, Schneider R, et al. 骨科内固定[M]. 3版. 荣国威, 翟桂华, 刘沂, 等, 译. 北京:人民卫生出版社, 1995:81-111.
4. 胥少汀, 葛宝丰, 徐印坎. 实用骨科学[M]. 3版. 北京:人民军医出版社, 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, 赵友明, 陶正刚, 等. 桡骨小头骨折与前臂骨间膜损伤的相关性研究[J]. 中华骨科杂志, 2012, 32(7):664-668.
8. 张贵林, 伊明江, 李楠, 等. 尺骨鹰嘴粉碎性骨折短缩固定后的肘关节功能研究[J]. 中华骨科杂志, 2003, 23(10):627-630.
9. Mezera K, Rockwood CA Jr. Fractures in adults[M]. 5th ed. Philadelphia:Lippincott Wikins, 200l:935-939.
10. 王世龙, 汤超亮, 张权, 等. 角稳定钢板结合关节面下支撑治疗关节面粉碎的尺骨鹰嘴骨折[J]. 中华骨科杂志, 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. 陈士鹤, 薛伟, 张学峰, 等. 微创钢板固定技术治疗肱骨干中下段骨折的疗效观察[J]. 黑龙江医学, 2010, 34(1):35-37.
13. 朱晨, 孔荣, 张先龙. 肘关节"恐怖三联征"的理论基础与研究进展[J]. 中华关节外科杂志:电子版, 2014, 8(3):383-387.
14. 张世民, 俞光荣, 袁锋, 等. 肘关节后脱位伴桡骨头和尺骨冠突骨折(恐怖三联征)5例初步报告[J]. 中国矫形外科杂志, 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. 张弛, 仲飙, 罗从风, 等. 外侧入路联合前内侧入路治疗肘关节"恐怖三联征"的手术疗效[J]. 中华骨科杂志, 2015, 35(4):320-327.
17. 王兮, 梁炳生. 尺骨冠突骨折分型及治疗进展[J]. 国际骨科学杂志, 2008, 29(5):304-306.
18. 蒋协远, 李庭, 张力丹, 等. 人工桡骨头置换治疗肘关节不稳定的桡骨头粉碎性骨折[J]. 中华骨科杂志, 2005, 25(8):467-471.
19. Schatzker J, Tile M. 骨折手术治疗原理[M]. 彭阿钦, 译. 3版. 北京:人民卫生出版社, 2007:90-123.
20. 严明明, 宋德业, 丁木亮, 等. 人工桡骨头置换治在肘关节恐怖三联征中的应用[J]. 中华骨科杂志, 2014, 34(6):652-658.
21. 李庭, 王满宜, 蒋协远, 等. 肘关节"恐怖三联征"的诊断与治疗[J]. 中华骨科杂志, 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. 王友华, 刘璠, 周振宇, 等. 尺骨近端粉碎性骨折伴肘关节不稳定的治疗[J]. 中华骨科杂志, 2008, 28(4):283-287.

West China Medical Journal

Surgical Treatment for Complicated Proximal Ulnar Fracture

Abstract Full text Figures/Tables Video References Cited by

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