目的 探讨应用前后路联合手术方式治疗尺骨鹰嘴并冠状突骨折的疗效.方法 回顾性分析2012年5月至2014年8月采用前后路联合手术方法治疗32 例尺骨鹰嘴并冠状突骨折,男21 例,女11 例;年龄26~57 岁,平均37. 7 岁.所有患者均采用前后联合入路,冠状突骨折使用微型接骨板给予固定,尺骨鹰嘴骨折使用解剖接骨板给予固定,术中均达到牢固固定.记录骨折复位、固定后是否有骨折复位丢失、骨折愈合时间和并发症情况.末次随访时采用Mayo肘关节功能评分(mayoelbowperformancescore,MEPS)评定肘关节功能.结果 28例患者术后获8~25个月(平均18个月)随访,4 例失访.所有患者骨折均获骨性愈合,愈合时间为6~18周,平均12. 8周.末次随访时肘部屈曲活动度113°~128°,平均125°;肘部伸直活动度0° ~30°,平均6°;前臂旋前54° ~82°,平均75°;旋后69° ~94°,平均81°.根据MEPS评分评定疗效,优20 例,良4 例,可2 例,差2 例,优良率为85. 7%.所有患者均无伤口深部感染,2 例患者出现肘关节僵硬.结论 应用前后路联合手术治疗尺骨鹰嘴并冠状突骨折,可以有效复位及固定牢靠,有利于肘关节早期功能锻炼.%Objective To explore the clinical efficacy of combined surgical approach of anterior and posterior for treat-ment of olecranon and coronoid fracture.Methods From May 2012 to August 2014,32 patients with ulnar olecranon and coro-noid fracture were treated in our department. There were 21 males and 11 females with an average age of 37. 7 years old(26 to 57 ). All the patients were treated through combined surgical approach of anterior and posterior,using micro plate and anatomi-cal plate to fix ulnar coronoid and olecranon fracture. Reduction reduction loss,fracture healing time and complications were documented. The elbow function was evaluated at the last follow-up by Mayo elbow performance score( MEPS). Results Twenty-eight patients were followed up for 8 to 25 months(average,18months),and 4 patients were lost.All the 28 patients obtained bony union after 6 to 18 weeks(average,12. 8 weeks). At the last follow-up,elbow flexion ranged from 113°to 128° (average,125°),elbow extension from 0° to 30°(average,6°),forearm pronation from 54°to 82°(average,75°),and supina-tion from 69°to 94°(average,81°). According to MEPS,20 patients were excellent,4 good,2 fair,and 2 poor. The excellent to good rate was 85.7%.None of the patients had deep wound infection.Two patients had elbow stiffness.Conclusion Com-bined surgical approach of anterior and posterior for treatment of olecranon and coronoid fracture can reduce effectively,fix firmly and enable function exercise of the elbow early.
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