Clinical Treatment of Epiphyseal Fracture of Coronoid Process of Ulna in Children

Sun Qiang; Ye Jiajun; Zhou Ying

Abstract：Objective To explore the characteristics and clinical treatment of ulnar coronal process epiphyseal fractures in children.Methods A retrospective analysis was performed on 102 children with ulnar coronal process epiphyseal fractures admitted to the Children's Orthopaedics Department of Sichuan Orthopaedics Hospital from January 2014 to January 2023.The cohort comprised 82 males and 20 females,with 54 fractures on the left side and 48 on the right.The age range was from 1 year,11 months to 14 years,6 months,with an average age of(9.53±3.27)years.Based on the Regan Morrey classification,there were 49 cases of type Ⅰ,27 cases of type Ⅱ,and 26 cases of typeⅢ fractures.Among these cases,39 were accompanied by elbow joint dislocation,and 75 were accompanied by fractures in other body parts.Fifty-nine cases underwent conservative treatment,while 43 cases underwent surgical intervention.Surgical fixation materials included a combination of hollow nails and Kirschner wires in 10 cases,Kirschner wires alone in 9 cases,and steel plates in 24 cases.Results All patients were followed up for a duration ranging from 10 months to 4 years and 9 months,with an average follow-up period of(30.02±8.77)months.Based on the Mayo elbow joint function evaluation criteria,the outcomes were classified as 81 excellent cases,17 good cases,and 4 fair cases,resulting in an excellent and good rate of 96.08％.Conclusion Coronary process epiphyseal fractures of the ulna in children are frequently accompanied by additional fractures and elbow joint dislocations.To avoid misdiagnosis,it is crucial to thoroughly investigate the patient's medical history and injury mechanisms,conduct a detailed physical examination,capture lateral images of the injured limb,and perform a CT plain scan or MRI.For Regan-Morrey type Ⅰ fractures and those with small fragments,minimal displacement,and a stable elbow joint,conservative treatment is often adopted.However,for comminuted fractures such as Regan-Morrey type Ⅱ and Ⅲ fractures,accompanied by elbow instability,fixation with micro T-shaped locking plates,hollow screws,or Kirschner wires through an anterior approach is more recommended,often resulting in a better prognosis in the later stages.