Treatment strategies and biomechanical analysis for ulna coracoid process fractures / 中国组织工程研究

ABSTRACT

BACKGROUND:Fractures of the coronoid progress are common in patients with elbow dislocations, and often accompanied by elbow ligament and joint capsule laceration. The coronoid progress fracture often leads to elbow joint instability, if cannot get the correct therapy, wil result in repeatedly elbow instability, dislocation, and cause long-term irreversible damage to the elbow. OBJECTIVE:To review the literatures about coronoid fractures and relative anatomic and biomechanical studies. METHODS:An electronic search of the Web of Science database was conducted for clinical and experimental researches about coronoid fractures and relative anatomic and biomechanics published from January 1990 to March 2013, the key words were“coronoid process of the ulna, coronoid fracture, treatment method, research progress”. The articles published earlier and repetitive researches were excluded. RESULTS AND CONCLUSION:Coronoid process is an important primary stabilizer of elbow joint, The coronoid process combined with the soft tissues of ligaments, joint capsule and muscles that attached on the coronoid plays an important role in maintaining the elbow axial, varus, valgus and rotation stability. The selection of the treatment strategies for coronoid process fracture depends on the fracture type, degree of fracture fragments crush and injury of medial and lateral col ateral ligament and the anterior capsule. Uncomminuted large fractures can be treated with open reduction and internal fixation;comminuted fractures can be treated with reduction and internal fixation by the largest fracture fragments, autograft reconstruction or artificial coronoid process replacement;the repair of smal coronoid process fracture depends on the circumstances;if the elbow gets enough stability after repair of soft tissue injury, it cannot be addressed, if not, the elbow should be repaired with sutures or anchors. Earlier motion after operation is important to get better function, and the hinged external fixator can be used if necessary.