The Exploration Of Ulna Coronoid Process Fracture Treatment

With the development of therapeutic level, ulna coronoid processfracture has gradually attracted attention of scholars.Ulna coronoidprocess is an important part of the humeroulnar joint，the ability tofunction in the elbow to the rear of limit stress，and play an important rolein against stress in the elbow straight.Many studies have shown that theheight of is one of the indispensable factors of elbow joint stability.Inelbow four-column theory, ulna coronoid process is an important part ofthe inside column and the anterior column.And there are a lot ofimportant anatomical tissue adhesion in ulna coronoid process and itsnearby, such as the anterior bundle of ulnar collateral ligament.A largenumber of anatomy and biomechanics study indicated ulna coronoidprocess plays an important role in maintaining stability of the elbow.Now,ulna coronoid process fractures are many ways of classification,which is widely used is Regan-Morrey classification and O`Driscollclassification. Regan-Morrey classification is relatively simple and isbased on the proportion of the bone fragment of ulna coronoidprocess.This classification is easy to be widely accepted and used, thecurrent mainstream use its guiding treatment. Another kind ofclassification method for O`Driscoll classification, in the elbow CTscans to make classification more comprehensive includes all ulna coronoid process fracture type, and is closely related to the occurrence offracture mechanism, hence the reliable prediction combined other elbowstructural damage.According to the above statement, the ulna coronoidprocess fracture classification method has guiding significance to surgicaltreatment.There is a close anatomic relationship between the radial joints,radial joint capsule, the anterior bundle of ulnar collateral ligament,humeroradial joint and ulna coronoid process.And ulna coronoid processfracture caused by high-energy injuries, lead to simple ulna coronaryhappens rarely, easily missed diagnosis or misdiagnosis. the surgicalapproach and the choice of internal fixation of ulna coronoid processfracture has a lot of kinds, and is still in continuous development andimprovement. For after the internal fixation operation, the function of theelbow joint also makes everyone attaches great importance to the elbowjoint function after exercise.To the right choice such as the surgicalapproach of ulna coronoid process fracture, internal fixation offracture,and good postoperative functional exercise time and intensitycan guarantee elbow joint effect after surgery for the treatment.Due to the ulna coronoid process plays an important role in maintainthe stability of the elbow, and ulna coronoid process fracture more closelyconnected with complex elbow fracture dislocation, make its surgicaltreatment, including specific surgical approach and the choice of internalfixation has gradually attracted widespread attention. ObjectiveExplore the surgical indications of ulna coronoid process fracture,the specific selection of surgical approach, internal fixation methods andpostoperative functional exercise.MethodSince2012-2014, a total of15patients with treatment for ulnacoronoid process fracture in the department of orthopaedics, China-JapanUnion Hospital Jilin University. Men and women, respectively, for10cases,5cases. According to the reason of fracture classification: fall7cases,6cases of traffic accident injury, high falling injury in2cases.Treatment: conservative treatment:3cases,12cases surgicaltreatment.According to the ulna coronary fracture classification todetermine the surgical approach:7cases of medial approach,3cases ofmiddle approach, and2cases of posterior approach. Simple fracture ofulna coronoid process in5cases;8cases of coronoid process fracturescombination of radial capitulum fracture and elbowdislocation; coronoidprocess fractures combined with fracture of radial capitulum and ulnaolecranon fracture in2case. According to the coronoid process fractureclassification determine fracture fixed way: no surgery, a plaster cast in3cases; The fracture open reduction and internal fixation with hollow nail8cases; open reduction and bone plate fixed4cases, Including1casewith hinged external fixator to guarantee postoperative stability of theelbow.The ruptured collateral ligament of the intraoperative explorationwere given one stage repair. Postoperatively external fixation of plaster orelbow support with a2weeks, after then start the elbow function of exercise.ResultsPatients with postoperative follow-up of patients6to12months,Surgical treatment of patients, all incision healed well, no incisioninfection. All the coronoid process fracture healing, healing time of3to6months. According to the elbow integrated in patients with elbow HHSscore evaluation:4cases were outstanding,cases of good, generally3cases with elbow stiffness. All the postoperative patients did not appearelbow dislocation again.ConclusionAffecting the joints and the stability of the elbow ulna coronoidprocess fractures require surgical treatment. Surgical approach andinternal fixation methods should be based on each patient of fractureclassification and the specific conditions of the other structural damage.Damage of ulnar collateral ligament should be given repair orreconstruction. Postoperative patients with elbow instability can be usedwith elbow support or with a hinged external fixator. Individualizedexercise program should be formulated according to every patient’sdamage degree and the function of the elbow joint stability.