La plaque Lasso. Un implant original pour le traitement des fractures Regan-Morrey I et II de la coronoïde ulnaire - 28/03/17

Lasso plate – an original implant for fixation of type I and II Regan-Morrey coronoid fractures

Doi : 10.1016/j.rcot.2017.02.004

P. Wang, Y. Zhuang, Z. Li, W. Wei, Y. Fu, X. Wei, K. Zhang ^⁎
Department of orthopedics and trauma, Xi’an Hong Hui Hospital, Xi’an Jiaotong University Health science center, No. 555, East Friendship Road, Xi’an City, Shaanxi Province, Chine

^⁎Auteur correspondant.

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Abstract

Introduction

Coronoid fractures are notoriously difficult to manage particularly when there is a small fragment. We report a retrospective analysis of our experience with consecutive type I and II Regan-Morrey coronoid fractures using a lasso plate.

Hypothesis

Type I and II Regan-Morrey coronoid fractures can be effectively managed using a lasso plate.

Methods

From October, 2011 and December, 2013, 25 patients (21 males and 4 females, mean age 40.0 years) with type I and II Regan-Morrey coronoid fractures were treated with the open reduction and internal fixation (ORIF) using the lasso plate. Postoperative measurements of the elbow range of motion were recorded. Elbow function was evaluated by the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm, Shoulder and Hand (DASH) score.

Results

All patients were re-examined at a mean follow-up of 32.7 months (range, 24–49 months). The mean fractures healing time was 13.6 weeks (range, 6–18 weeks). The mean flexion range of the elbow was 121.8° (range, 90°–135°), and the mean extention range of the elbow was 10.6° (range, 0°–20°). The mean pronation range of the forearm was 75.8° (range, 65°–85°). The mean supination range of the forearm was 80.4° (range 70°–90°). The mean DASH score was 10.2 (range 0–28). The mean MEPS was 83.4 (range 55–95), 8 patients (32 %) were rated excellent, 14 patients (56 %) were rated good, 2 (8 %) patients were rated fair. 1 (4 %) patient were rated poor. No patient was seriously infected, implant breakage was found in one case. Two cases of elbow heterotopic ossification (HO) were observed. Two cases of elbow medial instability were observed.

Discussion

The type I and II Regan-Morrey coronoid fractures combined with the instability of the elbow should be operated. The lasso plate reduces the pressure between the wire and the insertion of capsule. A tight wire results in greater stability than ordinary suture fixation, thus enabling early functional exercise.

Conclusion

In the treatment of type I and II Regan-Morrey coronoid fractures, lasso plate can provide concentric fracture reduction of the elbow and stable fixation to allow for early rehabilitation. Good clinical outcomes can be anticipated.

Level of evidence

Level IV: retrospective study.

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Keywords : Ulnar coronoid, Elbow, Fracture, Dislocation, Internal fixation, Lasso plate

☆	Cet article peut être consulté in extenso dans la version anglaise de la revue Orthopaedics & Traumatology: Surgery & Research sur Science Direct (sciencedirect.com) en utilisant le DOI ci-dessus.