Modified anterior approach for treatment of ulnar coronoid process fracture

Abstract

Objective To investigate the clinical effect of modified anterior approach to manage fracture of the ulnar coronoid process via the space of brachial artery and vein with median nerve. Methods From June 2012 to January 2013, 11 patients with ulnar coronoid fracture were fixed via the modified anterior approach. The operation time, intraoperative blood loss and postoperative complications were recorded. Flexion and rotation range of motion about the injured and normal elbow were observed during postoperative follow-up period. Function of elbow joint was evaluated by mayo elbow performance index (MEPI). Results There was approximate 8 cm in length and 5 cm in width between the brachial vessels and median nerve. Operated angle from radial to ulnar side was fifty degrees and from proximal to distal end was sixty degrees. All the patients were available for follow-up. The fracture healed, that is the elbow flexion restored [(130.7±5.0)°] was 96.6% of the unaffected elbow, elbow extension restored [(7.6±8.1)°] was 84.0% of the unaffected elbow, pronation restored [(86.9±3.8)°] was 98.2% of the unaffected side, and supination restored [(85.6±6.0)°] was 96.7% of the unaffected side. MEPI of the elbow joint was over 75 points. Conclusion Modified anterior approach is relatively safe and simple in operation and results in satisfactory function recovery of the elbow joint, providing a new surgical approach for treatment of coronoid process fracture. Key words: Elbow joint; Ulna; Fracture fixation, internal