探讨套索缝合技术治疗肘关节"恐怖三联征"中Regan-Morrey I/II型冠状突骨折的手术方式和临床疗效。

采用回顾性随访分析2018年1月至2022年6月，山西医科大学第二医院创伤骨科病区采用套索缝合技术治疗的18例肘关节"恐怖三联征"中冠状突Regan-Morrey I/II型骨折患者的临床资料及随访结果，其中男12例、女6例；年龄18~55岁,平均年龄32岁；其中摔伤12例、交通伤5例、高处坠落伤1例。所有患者都是Regan-Morrey I/II型骨折，外侧副韧带均有损伤，所有患者均采用单纯肘关节外侧入路，术中依次固定冠状突、桡骨小头，缝线锚钉修复损伤的外侧副韧带，内侧副韧带常规不给予处理。术后肘关节功能位石膏外固定2周后开始功能锻炼，术后3周、6周、12周定期门诊随访，术后肘关节评分采用Mayo肘关节功能评分（Mayo elbow performance score，MEPS）系统。

所有患者均获得了随访，随访时间3~52个月，平均18个月。所有骨折均获得愈合，末次随访时肘关节伸直为0~30°，屈曲为90~125°，平均活动度为103.61°，旋前10~90°，旋后20~90°，平均旋转142.78°。术后按照MEPS功能评分平均为88.89分（65~100分），优12例、良3例、可3例，优良率为83.3%，有3例患者出现骨化性肌炎的症状，有1例患者因为局部感染取出缝线锚钉。

在肘关节恐怖三联征中冠状突Regan-Morrey I/II型的骨折采用套索缝合技术固定冠状突骨折临床疗效是满意的。

Coronal process fracture and radial head fracture are accompanied by posterior dislocation of the elbow joint, which is called the "terror triad" by Hotchkiss. It consists of the elbow fracture and the medial and lateral collateral ligament injuries of the elbow joint, resulting in severe instability, which is very difficult in clinical treatment as one of the main factors affecting the stability of the elbow joint, coronal process fracture plays a pivotal role in preventing posterior dislocation of the elbow joint. There is no adequate internal fixation for the coronal process fracture fragment with conventional methods, so it has always been a difficult point in clinical treatment. The technique of suture lasso was used in the cases of coronal process fracture of Regan-Morrey type I/II, and the preliminary curative effect was obtained. Objective To explore the operative method and clinical effect of the suture lasso technique in treating Regan-Morrey type I/II coronal process fracture.

From January 2018 to June 2022, the clinical data and follow-up results of 18 patients with coronal process Regan-Morrey type I/II fracture in terror triad of the elbow treated with suture lasso technique were retrospectively analyzed, including 12 males and 6 females. Their ages ranged from 18 to 55 years, with an average age of 32 years. The causes of injuries included 12 cases of traffic injuries, 5 cases of high fall injuries, and 1 case of fall damage. All of them were type I/II according to the Regan-Morrey classification. All the lateral collateral ligaments were injured. All patients were treated through a lateral approach to reduce and fix fractures of the coronal process, radial head, and lateral collateral ligament. After the operation, the elbow joint was set in the functional position for 2 weeks, followed by functional exercise. The outpatients were followed up regularly for 3 weeks, 6 weeks, and 3 months after the operation. The postoperative elbow joint score was evaluated by the MEPS score system.

All patients were followed up for 3 to 52 months, with an average of 18 months. Bone union was achieved in all fractures. Elbow joint flexion position (0-30°), extension position (90-125°), with an average range of joint motion being 103.61°; pronation (10-90°), supination (20-90o), with an average rotation range of 142.78°. According to the MEPS Elbow Performance Index, the average postoperative score was 88.89 points (range 65-100 points). Among them, 12 cases were excellent, 3 were good, and 3 were moderate. The excellent and good rate was 83.3%. Three patients developed myositis ossificans. One patient took out the suture anchor due to infection.

In the terror triad of the elbow, the clinical effect of the lateral approach of the elbow joint using the suture lasso technique to fix the coronal process fracture of Regan-Morrey I/ II type fracture is satisfactory.