[EFFECTIVENESS OF ANTERIOR APPROACH FOR TREATING ANTEROMEDIAL FACET FRACTURES OF U LNAR CORONOID PROCESS].

OBJECTIVE: To explore the effectiveness of non-absorbable suture or suture anchor fixation by anterior approach in the treatment of anteromedial facet fractures of the ulnar coronoid process.

METHODS: Between February 2007 and February 2012, 16 cases of anteromedial facet fractures of the ulnar coronoid process were treated with operation. There were 9 males and 7 females, aged 20-80 years (mean, 43.5 years). The causes of injury were traffic accident injury in 7 cases, tumble injury in 5 cases, and falling injury from height in 4 cases. The time from injury to operation was 6.8 days on average (range, 2-8 days). All cases had closed fractures. According to O'Driscoll classification, there were 4 cases of type II a, 7 cases of type II b, and 5 cases of type II c. Among 16 patients, 7 had simple anteromedial facet fractures of the ulnar coronoid process, and 9 had associated injury, including terrible triad in 3, Monteggia fractures in 4, and olecranon fractures in 2. All fractures were fixed with non-absorbable suture in 10 cases, and with suture anchor in 6 cases. The Mayo Elbow Performance Score (MEPS), range of motion (ROM), and complications were used to assess the elbow function.

RESULTS: The incisions all healed by first intension, without neurovascular injury. Fifteen patients were followed up 10-48 months (mean, 25.3 months). The X-ray films showed that all fractures healed, with the mean healing time of 17.5 weeks (range, 11-30 weeks). At last follow-up, the mean MEPS score was 88.5 (range, 55-100); the results were excellent in 10 cases, good in 3 cases, fair in 1 case, and poor in 1 case, with an excellent and good rate of 86.7%. The mean ROM of flexion and extension was 118° (range, 35-145°), and the mean ROM of forearm rotation was 138° (range, 85-165°). One case had elbow instability, and 3 had slight pain. No heterotopic ossification and traumatic arthritis occurred during the follow-up.

CONCLUSION: The anteromedial facet fractures of the ulnar coronoid process can be clearly exposed through anterior approach, and the fracture fixation using non-absorbable suture and suture anchor fixation usually can restore the elbow function.