Treatment for ulnar coronoid fracture in 20 children

Abstract:

Objective：To explore the characteristics and treatment for ulnar coronoid fracture in 20 children. Methods：From January 2012 to January 2017，20 children suffered from fracture of the coronoid process of the ulna were treated in the Children’s Hospital of Chongqing Medical University，including 16 boys and 4 girls，aged from 1 to 15 year with a mean age of 9.9 years. According to Regan-morrey classification，there were 10 cases of type I，7 cases of typeⅡ，3 cases of type Ⅲ. Eight cases were comminuted fracture，12 cases were concomitant with other fractures，3 cases were accompanied with elbow dislocation，and no case of ‘terrible triad of the elbow’ or ligament rupture was found. A total of 6 cases were treated conservatively while the other 14 cases were managed by operation：cannulated screw in 1 case，cartilage nails in 7 cases，Kirschner wire in 2 cases，absorbable suture in 1 case，removing the small bone fragments in 3 cases. Results：Mean follow up was 2.7 years（1 to 5 years）. According to Mayo scale，the functional re－covery assessed as excellent in 16 cases，good in 3 cases and fair in 1 case. Conclusion：In children，the incidence of ulnar coronoid fracture is rare，while most of them are comminuted fracture，and few are concomitant with the ‘terrible triad of the elbow’ and liga－ment rupture. The lateral X-ray examination can reduce the missed diagnosis. The prognosis of ulnar coronoid fracture is good，with few complications. The anterior approach is recommended for operation in cases with comminuted fracture in which cartilage nail or the Kirschner wire is recommended to fix.