Mini-plate fixation of ulnar coronoid process fracture via anteromedial approach

Abstract

Objective To investigate the clinical efficacy of mini-plate fixation for ulnar coronoid process fracture via anteromedial approach. Methods A retrospective review was made on 28 cases of ulnar coronoid process fracture treated with open reduction and mini-plate fixation from April 2010 to December 2014. There were 18 males and 10 females, with age range of 21-60 years(mean, 34.3 years). Causes of injury were falls in 21 cases and traffic accidents in 7 cases. According to the O’Driscoll classification, there were 14 cases of type Ⅰ, 11 cases of type Ⅱ and 3 cases of type Ⅲ. Time from injury to operation was 2-10 d(mean, 3.7 d). Reduction loss, fracture healing time and complications were documented.Elbow function was evaluated at the last follow-up by Mayo elbow performance score(MEPS)and Broberg & Morrey score. Results All cases were followed up for 12-25 months(mean, 15.1 months). Restricted elbow activity was initiated one week after operation. Bone united in mean 10.6 weeks(range, 8-14 weeks). No nerve injury or fracture redisplacement occurred. At the final follow-up, mean flexion was(124±15)°(range, 90°-140°), mean extension loss was(18±20)°(range, 0°- 50°), mean pronation was(65±18)°(range, 40°- 85°), and mean supination was(63±16)°(range, 35°- 85°), showing significant difference in comparison with the preoperative measure(P<0. 05). According to the MEPS, the results were excellent in 17 cases, good in 8, fair in 2 and poor in 1. According to the Broberg & Morrey score, the results were excellent in 16 cases, good in 8, fair in 3 and poor in 1. Conclusion Through anteromedial approach, mini-plate fixation of the ulnar coronoid process fracture provides rigid fixation, which benefits joint stability and bone union, and allows early functional exercise. Key words: Unlar fractures; Fracture fixation, internal; Mini-plate