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Clin Shoulder Elbow > Volume 12(2); 2009 > Article
Journal of the Korean Shoulder and Elbow Society 2009;12(2):159-166.
DOI: https://doi.org/10.5397/CiSE.2009.12.2.159    Published online December 31, 2009.
Improvement of the Elbow Function with Early Mobilization and Rigid Fixation of Coronoid Fracture by Tension Band Technique
In Hyeok Rhyou, Bo Gun Suh, Hyung Jin Kim, Chaeik Chung, Kyung Chul Kim
Upper Extremity and Microsurgery Center, Department of Orthopedic Surgery, Semyeong Christianty Hospital, Pohang, Kyeongbuk, Korea. inhyeok_r@yahoo.co.kr
압박 긴장대 방법을 이용한 구상 돌기 골절의 견고한 고정과 조기 운동을 통한 주관절 기능의 향상
류인혁·서보건·김형진·정재익·김경철
포항세명기독병원 정형?성형센터
Abstract
PURPOSE
We wanted to evaluate the surgical results of early mobilization after rigid fixation of small coronoid fracture using the tension band technique MATERIALS AND METHODS: Eight cases of coronoid fracture were fixed with the tension band technique and using K-wire and wire through the medial approach. All the cases were Regan-Morrey type 2. According to O'Driscoll, they were classified as 5 cases of the tip type (subtype 2) and 3 cases of the anteromedial type (1 case of subtype 2, and 2 case of subtype 3). The associated collateral ligament injuries (6 cases) and radial head/neck fractures (4 cases) were managed simultaneously. After immobilization for 5~7 days, active ROM exercise with a fitted hinge brace started and continued till postoperative 6 weeks. The patients were assessed for pain, ROM and functional disability using the Mayo elbow performance score (MEPS) at an average of 11 months (range: 6~28 months). The ulnar nerve symptoms were also investigated.
RESULTS
We observed solid union in all the coronoid fractures without hardware failure. An average of 2.2 wires (range: 2~4) were used. The mean extension was 3degrees (range: 0degrees~25degrees), the mean flexion was 137degrees (range: 130degrees~140degrees), the mean pronation was 69degrees (range: 45degrees~90degrees) and the mean supination was 78degrees (range: 45degrees~90degrees). The mean MEPS was 96 (range: 65~100). Ulnar nerve symptoms occurred at postoperative one day and persisted in one patient with the terrible triad of taking radial head excision and residual medial instability.
CONCLUSION
The tension band technique uses easily obtained, economic K-wires and the wire was strong enough to permit early elbow ROM exercise and the technique might improve the elbow function. It was especially useful for fixation of multiple small fragments.
Key Words: Elbow joint; Coronoid process fracture; Tension band technique
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