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Kuang X.,Central Hospital of Yiwu
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery | Year: 2011

To explore the operation procedure and effectiveness of terrible triad of the joint. Between October 2006 and June 2010, 11 cases of closed terrible triad of the elbow joint were treated operation. There were 8 males and 3 females with an average age of 32 years (range, 21-53 years). The mechanism of was falling from height in 4 cases and traffic accident in 7 cases. The time from injury to admission was 30 minutes to According to Regan-Morrey classification for fractures of the ulnar coronoid, there were 5 cases of type I, 5 cases of type case of type III; and according to Mason classification for fractures of the radial head, there were 4 cases of type I, 5 cases II, and 2 cases of type III. The elbow joint range of motion (ROM) was (63 +/- 9) degrees at flexion and extension, and the forearm was (71 +/- 8) degrees at pronation and supination. All cases underwent reduction and fixation by lateral approach combined with approach according to McKeeps operation process. After operation, the affected limb was immobilized with plaster at joint flexion of 90 degrees and in forearm neutral position, then passive physical exercises were carried out, and finally active exercises were done after removing plaster at 4 weeks. All incisions healed by first intention. Eleven cases followed up 7-27 months (14.5 months on average). The X-ray films showed good reduction, the clinical healing time was weeks with an average of 11 weeks. Mild ectopic ossification of the elbow joint occurred in 3 cases at 6 months after operation, mild degenerative change in 1 case at 18 months after operation. At last follow-up, the elbow joint ROM was (103 +/- flexion and extension, and the forearm ROM was (122 +/- 13) degrees at pronation and supination, showing no significant difference when compared with the values of normal elbow joint (P > 0.05) and significant difference when compared with the preoperative values of affected elbow joint (P < 0.05). According to Mayo elbow performance score, the results were excellent in 5 cases, in 5 cases, and fair in 1 case with an excellent and good rate of 90.9%. The surgical treatment of terrible the elbow joint can restore sufficiently elbow stability, allow early motion postoperatively, and enhance the functional outcome. Source


Kuang X.,Central Hospital of Yiwu
Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery | Year: 2010

To investigate the treatment of ulnar coronoid process fracture with mini-plate and to evaluate the clinical results. Between September 2006 and March 2009, 14 patients with ulnar coronoid process fracture were treated with open reduction and internal fixation of mini-plate. There were 10 males and 4 females with an average age of 29 years (range, 14-51 years). Fracture was caused by falling from height in 4 cases and traffic accident in 10 cases. The locations were left side in 6 cases and right side in 8 cases. According to Regan-Morrey classification, there were 2 cases of type I, 6 of type II, and 6 of type III. The flexion-extension are of the elbow was (60 +/- 10)0 and the forearm rotation was (70 +/- 10) degrees. The disease duration was 30 minutes to 11 days, and CT scan was used for definite diagnosis. Patients received early functional exercise 1 week postoperatively. All incisions healed by first intention. Fourteen cases were followed up 12-25 months (17 months on average). All fractures healed well, and the average union time was 10 weeks with a range of 7-12 weeks. No loosening or breakage of the internal fixation occurred except for 2 patients who had heterotopic ossification. The flexion-extension arc of the elbow was (110 +/- 10) degrees and the forearm rotation was (130 +/- 15) degrees, showing significant difference when compared with that before operation (P < 0.05). The clinical results were evaluated according to Morrey's scale, 8 cases were rated as excellent, 4 as good, and 2 as fair; the excellent and good rate was 85.7%. Fixation of ulnar coronoid process fracture with mini-plate provides sufficient stability to do early functional exercise and it can enhance functional outcome. Source

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