CAJ | 학술논문

目的探讨经肱动静脉和正中神经间隙的改良前侧入路治疗尺骨冠状突骨折的临床效果. 方法 2012年6月-2013年1月应用改良前侧入路治疗尺骨冠状突骨折11例,其中男8例,女3例;年龄19 ～55岁[(42.7±9.8)岁].致伤原因:交通伤7例,摔伤3例,击打伤1例.单纯尺骨冠状突骨折4例,“恐怖三联征”7例.按Regan-Morrey分型:Ⅱ型6例,Ⅲ型5例;按O'Driscoll分型:冠状突尖骨折4例,冠状突前内侧面骨折5例,基底部骨折2例.记录手术时间、术中出血量及术后并发症等.术后随访记录伤肘和正常肘的屈伸旋转活动度,并与正常侧进行比较.应用梅奥肘关节功能指数(MEPI)评分评价肘关节功能. 结果改良前侧入路肱动静脉与正中神经之间纵向分离长度约8 cm,横向牵拉宽度约5 cm,在桡侧和尺侧的手术操作角度达50°,远侧和近侧达60°.患者均获得随访,骨折愈合良好.屈肘(130.7±5.0)°,为正常侧的96.6％;伸肘(7.6±8.1)°,为正常侧的84.0％;旋前(86.9±3.8)°,为正常侧的98.2％;旋后(85.6±6.0)°,为正常侧的96.7％.MEPI评分均＞75分. 结论改良前侧入路相对安全且操作简单,术后功能恢复满意,为冠状突骨折的手术治疗提供一种新的入路选择.
목적 탐토경굉동정맥화정중신경간극적개량전측입로치료척골관상돌골절적림상효과. 방법 2012년6월-2013년1월응용개량전측입로치료척골관상돌골절11례,기중남8례,녀3례;년령19 ～55세[(42.7±9.8)세].치상원인:교통상7례,솔상3례,격타상1례.단순척골관상돌골절4례,“공포삼련정”7례.안Regan-Morrey분형:Ⅱ형6례,Ⅲ형5례;안O'Driscoll분형:관상돌첨골절4례,관상돌전내측면골절5례,기저부골절2례.기록수술시간、술중출혈량급술후병발증등.술후수방기록상주화정상주적굴신선전활동도,병여정상측진행비교.응용매오주관절공능지수(MEPI)평분평개주관절공능. 결과 개량전측입로굉동정맥여정중신경지간종향분리장도약8 cm,횡향견랍관도약5 cm,재뇨측화척측적수술조작각도체50°,원측화근측체60°.환자균획득수방,골절유합량호.굴주(130.7±5.0)°,위정상측적96.6％;신주(7.6±8.1)°,위정상측적84.0％;선전(86.9±3.8)°,위정상측적98.2％;선후(85.6±6.0)°,위정상측적96.7％.MEPI평분균＞75분. 결론 개량전측입로상대안전차조작간단,술후공능회복만의,위관상돌골절적수술치료제공일충신적입로선택.
Objective To investigate the clinical effect of modified anterior approach to manage fracture of the ulnar coronoid process via the space of brachial artery and vein with median nerve.Methods From June 2012 to January 2013,11 patients with ulnar coronoid fracture were fixed via the modified anterior approach.The operation time,intraoperative blood loss and postoperative complications were recorded.Flexion and rotation range of motion about the injured and normal elbow were observed during postoperative follow-up period.Function of elbow joint was evaluated by mayo elbow performance index (MEPI).Results There was approximate 8 cm in length and 5 cm in width between the brachial vessels and median nerve.Operated angle from radial to ulnar side was fifty degrees and from proximal to distal end was sixty degrees.All the patients were available for follow-up.The fracture healed,that is the elbow flexion restored [(130.7 ±5.0) °] was 96.6％ of the unaffected elbow,elbow extension restored [(7.6 ± 8.1) °] was 84.0％ of the unaffected elbow,pronation restored [(86.9 ± 3.8) °] was 98.2％ of the unaffected side,and supination restored [(85.6 ± 6.0) °] was 96.7％ of the unaffected side.MEPI of the elbow joint was over 75 points.Conclusion Modified anterior approach is relatively safe and simple in operation and results in satisfactory function recovery of the elbow joint,providing a new surgical approach for treatment of coronoid process fracture.