gms | German Medical Science

Objectives: To explore the clinical efficacy of combined surgical approach of anterior and posterior for treatment of ulnar coronoid fracture of O'Driscoll type 3b.

Methods: From December 2015 to March 2018. 18 patients with ulnar coronoid fracture of O'Driscoll type 3b were treated in our department. They were 12 males and 6 females.29 to 52 years of age (mean,38.6 years). All the patients were treated through combined surgical approach of anterior and posterior, using micro plate and anatomical plate to fix ulnar coronoid and olecranon fracture respectively. Reduction,reduction loss,fracture healing time and complications were documented. The elbow function was evaluated at the last follow-up by Mayo elbow performance score (MEPS).

Results: 16 patients were followed up for 9 to 20 months (average,16.2 months),and 2 patients were lost. All the 16 patients obtained bony union after 6 to 16 weeks (average,11.8 weeks). At the last follow-up,elbow flexion ranged from 108°to 125°(average,115°),elbow extension from 0° to 38°(average,8°),forearm pronation from 55°to 85°(average,78°),and supination from 70°to 87°(average,84°). According to MEPS,12 patients were excellent,1 good,1 fair,and 2 poor. The excellent to good rate was 83.2%. None of the patients had deep wound infection. One patients appeared elbow stiffness, one patients appeared elbow heterotopic ossification.

Conclusions: Combined surgical approach of anterior and posterior for treatment of ulnar coronoid fracture of O'Driscoll type 3b can result in good efficacy because it allows reduction under direct vision,leads to rigid fixation.