Revue de chirurgie orthopédique et traumatologique 103 (2017) 628

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Mémoire original

Une nouvelle voie d’abord antérieure pour la synthèse des fractures

de l’apophyse coronoïde au coude夽
A novel anterior approach for the fixation of ulnar coronoid process fractures
X. Yang a,1 , W. Chang b,1 , W. Chen b , S. Liu b , Y. Zhu b , Y. Zhang b,∗
a
Second division of department of orthopedic surgery, affiliated hospital of Chengde Medical College, 067000 Chengde, Chine
b
Department of orthopedic surgery, the Third hospital of Hebei medical university, 139, Ziqiang road, 050051 Shijiazhuang, Chine

i n f o a r t i c l e a b s t r a c t

Historique de l’article : Background. – There is no universally accepted approach to the elbow for the fixation of coronoid process
Reçu le 27 novembre 2016 fractures. This study aims to introduce a novel anterior surgical approach for the fixation of the ulnar
Accepté le 2 mai 2017 coronoid fracture, with minimal surgical dissection damage and excellent visualization for reduction and
internal fixation.
Keywords: Hypothesis. – The anterior approach can facilitate satisfactory outcomes for coronoid process fractures.
Elbow Material and methods. – From February 2010 to July 2014, 12 patients (8 males and 4 females; range:
Coronoid process
14–62 years; mean age: 31 years) with a closed fracture of the coronoid process of the ulna were included
Fracture
Anterior approach
in this study. According to Adams classification, we included 5 type II, 3 type III, 3 type IVAM, and 1 type
Internal fixation IVAL. The fractures were treated operatively via an anterior approach between nerves and blood vessels.
The anatomical reduction and fixation with cannulated screws or a mini plate was easily performed. One
elbow showed significant joint instability, necessitating, another incision to repair the lateral collateral
ligament, and a subsequent operation with a hinged external fixator was required. The remaining patients
received a splint for 2 weeks followed by functional exercises.
Results. – Mean follow-up was 21 months (13–36). Fracture union was achieved in each patient. The
arc of elbow flexion and extension were (135 ± 15)◦ , and forearm pronation/supination were restored to
(165 ± 15)◦ . When compared with the normal side, there was no significant difference in the functional
outcome (P > 0.05). According to Morrey’s scale, the functional recovery of the injured arms was assessed
as excellent in eleven patients and good in one. Mild heterotopic ossification was found in one case, which
had not impaired the elbow function. No other complications were noted.
Conclusions. – The anterior approach has the benefits of simplicity, safety, minimal invasion, excellent
exposure, and satisfactory prognosis for coronoid process fractures.
Level of evidence. – Prospective study, level IV.
© 2017 Published by Elsevier Masson SAS.

DOI de l’article original : http://dx.doi.org/10.1016/j.otsr.2017.05.020.

夽 Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (www.sciencedirect.com)
en utilisant le DOI ci-dessus.
∗ Auteur correspondant.
Adresse e-mail : dryzzhang12@126.com (Y. Zhang).
1
Ces auteurs ont contribué de façon égale à la réalisation du manuscrit.

http://dx.doi.org/10.1016/j.rcot.2017.06.020
1877-0517/© 2017 Publié par Elsevier Masson SAS.