Efficacy of internal fixation with mini plate and internal fixation with hollow screw for Regan-Morrey type II and III ulna coronoid fractures

Abstract

BackgroundUlna coronoid fracture is a complicated injury and occurred in the coronal plane. Undeniably, there is no universally accepted approach for treating ulna coronoid fractures. Therefore, this study aimed at exploring the efficacy of different surgical treatments for Regan-Morrey type II and III ulna coronoid fractures.MethodsA total of 164 patients with ulna coronoid fractures were admitted and treated in department of orthopedics at Yiwu Central Hospital, the Affiliated Yiwu Hospital of Wenzhou Medical University for retrospective analysis. The baseline features (age, gender, time from injury to surgery and so on) before the surgery and different conditions during the surgery were compared. Following that, the Visual Analogue Scale (VAS) pain score was employed to evaluate the severity of preoperative and postoperative pain experienced by the patients in each group. Afterwards, Broberg and Morrey elbow score was used to evaluate elbow joint function and surgical effect of the patients. Lastly, the postoperative recovery and complications were compared.ResultsIt was firstly observed that internal fixation with mini plate and hollow screw compelled to lower average operation time and blood loss than Kirschner wire and steel wire suture. Next, the severity of postoperative pain was lessened in comparison with preoperative pain. Afterwards, mini plate and hollow screw improved elbow joint function more notable than Kirschner wire and steel wire suture, and Kirschner wire and steel wire suture resulted in higher incidence of complications and worse postoperative recovery.ConclusionCollectively, this study clarified that for the treatment of Regan-Morrey type II and III ulna coronoid fractures, internal fixation with mini plate and hollow screw has an overall superior surgical effect than internal fixation with Kirschner wire and steel wire suture.

Direct anterior approach for mini plate fixation of Regan–Morrey type II comminuted ulnar coronoid process fracture

“…Because of the special anatomical and biomechanical features of the coronoid process, a fracture, especially Journal of Orthopaedic Surgery 27 (1) combined with elbow dislocation and collateral ligament injury, requires surgical treatment. The optimal management of the coronoid fracture remains controversial, including approach 7 and implant. Repair of coronoid fractures has been usually described from medial, 14,15 lateral, 15 and posterior approaches 6,15 as well as a combination of these.…”

“…Options include a suture lasso technique, 14 suture anchors, 14,17 lag screws, 14,17,24,25 or plates. 5,7,14,15,26 Garrigues et al 14 reported that a retrospective chart review performed at three tertiary care centers identified 40 consecutive patients treated for terrible triad injuries of the elbow with a minimum follow-up of 18 months. They found that suture lasso fixation of the coronoid fracture leads to fewer complications and improved outcomes compared with screw or suture anchor fixation techniques.…”

“…Because of the special anatomical and biomechanical features of the coronoid process, a fracture, especially combined with elbow dislocation and collateral ligament injury, requires surgical treatment. The optimal management of the coronoid fracture remains controversial, including approach 7 and implant.…”

“…6 Various approach and implants for coronoid fixation have been described. There is no universally accepted approach 7 and implant to the elbow for the fixation of coronoid process fractures. The type II comminuted coronoid process fracture usually appears as many small piece fragments.…”