Treatment of ulnar coronoid process fractures through the medial operative approach of double windows in a single incision

Abstract

Objective To analyze the related anatomical characteristics around ulnar coronoid process, design the medial operative approach of double windows in a single incision to expose ulnar coronoid process, and explore the surgical methods and clinical effects of this approach in the treatment of ulnar coronoid process fractures. Methods Three adult cadaveric specimens (6 sides) were used to perform anatomy research related to ulnar coronoid process of elbow joint. The reasonable methods of exposure and internal fixation of ulnar coronoid process were discussed. We designed the medial operative approach of two windows in a single incision and simulated operation. 11 cases of ulnar coronoid process fractures were treated by open reduction and internal fixation through the approach. After the operation, the adjustable orthosis of elbow joint were used for 4 to 6 weeks. The flexion and extension function of the elbow joint was gradually exercised 1 week after the operation. The elbow joint function was evaluated by MEPS and Broberg-Morrey scoring system at the last follow-up. Results All the patients were follow-up for 12 to 24 months with an average of 15.5 months. All the fractures achieved primary healing without complications of neurovascular injury. No fracture re-displacement and internal fixation failure occurred. The MEPS score of the last follow-up was excellent in 6 cases, good in 4 cases and fair in 1 case. Conclusion The medial operative approach of double windows in a single incision for the treatment of ulnar coronoid process fractures can provide good exposure, which is conducive to fracture reduction and fixation with satisfactory clinical effects. Key words: Fracture fixation, internal; Treatment outcome; Ulnar coronoid process; Operative approach