[EFFECTIVENESS OF ANTERIOR APPROACH FOR TREATING ANTEROMEDIAL FACET FRACTURES OF U LNAR CORONOID PROCESS].

OBJECTIVE

To explore the effectiveness of non-absorbable suture or suture anchor fixation by anterior approach in the treatment of anteromedial facet fractures of the ulnar coronoid process.

METHODS

Between February 2007 and February 2012, 16 cases of anteromedial facet fractures of the ulnar coronoid process were treated with operation. There were 9 males and 7 females, aged 20-80 years (mean, 43.5 years). The causes of injury were traffic accident injury in 7 cases, tumble injury in 5 cases, and falling injury from height in 4 cases. The time from injury to operation was 6.8 days on average (range, 2-8 days). All cases had closed fractures. According to O'Driscoll classification, there were 4 cases of type II a, 7 cases of type II b, and 5 cases of type II c. Among 16 patients, 7 had simple anteromedial facet fractures of the ulnar coronoid process, and 9 had associated injury, including terrible triad in 3, Monteggia fractures in 4, and olecranon fractures in 2. All fractures were fixed with non-absorbable suture in 10 cases, and with suture anchor in 6 cases. The Mayo Elbow Performance Score (MEPS), range of motion (ROM), and complications were used to assess the elbow function.

RESULTS

The incisions all healed by first intension, without neurovascular injury. Fifteen patients were followed up 10-48 months (mean, 25.3 months). The X-ray films showed that all fractures healed, with the mean healing time of 17.5 weeks (range, 11-30 weeks). At last follow-up, the mean MEPS score was 88.5 (range, 55-100); the results were excellent in 10 cases, good in 3 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 86.7%. The mean ROM of flexion and extension was 118° (range, 35-145°), and the mean ROM of forearm rotation was 138° (range, 85-165°). One case had elbow instability, and 3 had slight pain. No heterotopic ossification and traumatic arthritis occurred during the follow-up.

CONCLUSION

The anteromedial facet fractures of the ulnar coronoid process can be clearly exposed through anterior approach, and the fracture fixation using non-absorbable suture and suture anchor fixation usually can restore the elbow function.