Correlation between fragment size of ulnar coronoid process fracture and patient prognosis
10.3760/cma.j.cn115530-20210704-00323
- VernacularTitle:尺骨冠状突骨折块体积与患者预后的相关性分析
- Author:
Kai FENG
1
;
Tianen XU
;
Kang LI
;
Jingsheng LIU
Author Information
1. 兰州大学第二医院创伤骨科 730030
- Keywords:
Elbow joint;
Coronoid process fracture;
Relativity;
Linear-regression analysis
- From:
Chinese Journal of Orthopaedic Trauma
2021;23(11):963-968
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationship between fragment size of ulnar coronoid process fracture and patient prognosis.Methods:A retrospective study was conducted of the 34 patients who had been treated at Department of Orthopaedics, The Second Hospital Affiliated to Lanzhou University for fracture of ulnar coronoid process combined with elbow dislocation from July 2016 to December 2020. They were assigned into 2 groups according to their different treatments. In the surgery (internal fixation) group of 23 cases, there were 15 males and 8 females, aged from 22 to 71 years; in the conservative treatment group of 11 cases, there were 8 males and 3 females, aged from 38 to 78 years. Preoperatively, the sizes of coronoid process and fracture fragments were measured by elbow CT scan and 3D reconstruction, and a size-weighted ratio Z (%) corresponding to the fragment of coronoid process fracture was calculated. At the last follow-up, American Hospital for Special Surgery total elbow scoring system (HSS2) score was used to assess their therapeutic efficacy, the correlation between the ratio Z and HSS2 score for elbow function was calculated, and complications were recorded.Results:There were no significant differences between the surgery and conservative treatment groups in gender or age ( P>0.05). All the 34 patients were followed up for 18 to 54 months (average, 36.7 months). At the last follow-up, the HSS2 score was 93.77±0.84 (from 82 to 98) for the surgery group and 86.00±1.42 (from 78 to 90) for the conservative treatment group; the complications rate was 13.04% (3/23) for the former and 63.64% (7/11) for the latter. There was a linear relationship between the size-weighted ratio Z of the coronoid fracture fragment and the HSS2 elbow function score in the surgery group ( P<0.01). The linear regression equation between them was: y=99.44-0.121x ( r2=0.86, P<0.01). There was a linear relationship between the size-weighted ratio Z of the coronoid fracture fragment and the HSS2 elbow function score in the conservative treatment group ( P<0.01). The linear regression equation between them was: y=89.46-0.144x ( r2=-0.91, P<0.01). When a HSS2 elbow joint function score 90 was substituted into both linear regression equations, the results were x=78.02 for the surgery group and x=3.75 for the conservative treatment group. Conclusions:Conservative treatment may not lead to a satisfactory prognosis for the patients with coronoid process fracture whose size-weighted ratio of fracture fragment is larger than 3.75. Open reduction and internal fixation usually leads to a satisfactory prognosis for those whose size-weighted ratio of fracture fragment is smaller than 78.02.
