Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Původní práce / Original papers

ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE ČECHOSL.,
85, 2018, p. 102 - 108

Použití "mother-child" šroubů v léčení zlomenin processus coronoideus u  nešťastné triády loketního kloubu

Use of Mother-Child Screws in the Treatment of Coronoid Fractures in Terrible Triad Injury of the Elbow

Y. SHI1, G.-F. WANG1, K. MEI1, J. ZHANG1, C.-J.YUN1, C. QIAN1, J.-Y. SUN2
1 Department of Orthopaedic Surgery, The Affiliated Wujin Hospital of Jiangsu University, Changzhou, China
2 Department of Orthopaedic Surgery, The First Affiliated Hospital of Soochow University, Suzhou, China

ABSTRACT

PURPOSE OF THE STUDY

This study aims to analyze the clinical and radiographic outcomes of a  consecutive series of 18 patients with terrible triad injury. The coronoid fractures of these patients were repaired using Mother-Child screw (MCS).

MATERIAL AND METHODS

Twelve men and six women (mean age: 47.2 years) with terrible triad injury of the elbow were followed up for a mean of 17.6 months (range: 13-42 months). Surgical treatment consisted of open reduction and internal fixation of coronoid fractures with MCS, radial head fracture with MCS (Mason type II, n = 10), or mini-plate (Mason type III, n = 3). Furthermore, all underwent lateral collateral ligament repair (n = 9, 100%), and in cases of persistent instability, medial collateral ligament repair was performed (n = 3, 33%).

RESULTS

At last follow-up, average arc of ulnohumeral motion was 130° (range: 65° to 150°), average arc of forearm rotation was 148° (range: 100°-160°), mean Disabilities of the Arm, Shoulder and Hand (DASH) score was 7.1 (range: 0-28.5), and mean Mayo Elbow Performance Score (MEPS) was 92 (range: 70-100). According to the Mayo Elbow Performance Index (MEPI), 10 patients were excellent in, seven patients were good, and one patient was fair. All patients had a stable elbow. No secondary coronoid fragment dislocation or implant failures was reported. Fracture healing was observed in all patients.

CONCLUSIONS

This study shows that coronoid fracture treatment with MCS may be a new, effective and easy therapeutic option in terrible triad injury.

Key words: terrible triad of the elbow, coronoid process, radial head, functional outcome

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