内外侧联合入路手术治疗肘关节三联征
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汪宇 WANG Yu 南方医科大学附属东莞人民医院骨科, 广东 东莞 523059 Department of Orthopaedics, Dongguan People's Hospital Affiliated to South Medical University, Dongguan 523059, Guangdong, China wangyu0955@sina.com 
庞广兴 PANG Guang-xing 南方医科大学附属东莞人民医院骨科, 广东 东莞 523059 Department of Orthopaedics, Dongguan People's Hospital Affiliated to South Medical University, Dongguan 523059, Guangdong, China  
张海滨 ZHANG Hai-bin 南方医科大学附属东莞人民医院骨科, 广东 东莞 523059 Department of Orthopaedics, Dongguan People's Hospital Affiliated to South Medical University, Dongguan 523059, Guangdong, China  
刘先银 LIU Xian-yin 南方医科大学附属东莞人民医院骨科, 广东 东莞 523059 Department of Orthopaedics, Dongguan People's Hospital Affiliated to South Medical University, Dongguan 523059, Guangdong, China  
黎松波 LI Song-bo 南方医科大学附属东莞人民医院骨科, 广东 东莞 523059 Department of Orthopaedics, Dongguan People's Hospital Affiliated to South Medical University, Dongguan 523059, Guangdong, China  
期刊信息:《中国骨伤》2016年,第29卷,第7期,第662-664页
DOI:10.3969/j.issn.1003-0034.2016.07.017
基金项目:
中文摘要:

目的:探讨内外侧联合入路手术治疗肘关节三联征的临床疗效。

方法:自2010年5月至2014年5月,采用内外侧联合入路治疗肘关节三联征患者11例,其中男6例,女5例;年龄 25~56岁,平均 35.2 岁。伤后至手术时间1~13 d,平均5.9 d.桡骨头骨折按改良的Mason分型:Ⅰ型2例,Ⅱ型7例,Ⅲ 型2例。尺骨冠突骨折按Regan-Morrey分型:Ⅰ型3例,Ⅱ型7例,Ⅲ型1例。观察术后并发症,并采用 Mayo 肘关节功能评分进行肘关节功能评价。

结果:11例患者均获得随访,时间6~24个月,平均15.5个月,且均获得骨性愈合,愈合时间10~18周,平均14周。采用Mayo肘关节功能进行评价,总分为78.2±11.7,其中优2例,良7例,可1例,差1例。在末次随访时,患侧肘关节屈曲(108±21)°,伸直(12±8)°,旋前(66±13)°,旋后(28±18)°,其中有3例患者存在5°~8°内翻角,1例患者存在8°外翻角。

结论:内外侧联合入路治疗肘关节三联征能获得较好的功能恢复,恢复肘关节稳定,术后可早期活动,促进关节功能恢复。
【关键词】肘关节  肘关节三联征  尺骨冠突骨折  桡骨头骨折
 
Surgical treatment for terrible triad of the elbow through medial and lateral approach
ABSTRACT  

Objective: To investigate the clinical effects of medial and lateral approach in treating terrible triad of the elbow.

Methods: From May 2010 from May 2014, 11 patients with terrible triad of the elbow were treated through medial and lateral approach. There were 6 males and 5 females, aged from 25 to 56 years with an average of 35.2 years old. The time from injury to operation was from 1 to 13 days with an average of 5.9 days. Fracture of radial head according to Mason typing, 2 cases were type Ⅰ, 7 cases were type Ⅱ, 2 cases were type Ⅲ。 Ulnar coronoid fracture according to Regan-Morrey typing, 3 cases were type Ⅰ, 7 cases were type Ⅱ, 1 case was type Ⅲ。 Postoperative complications were observed and Mayo elbow performance score(MEPS) was used to assess the elbow joint function.

Results: All patients were followed up from 6 to 24 months with an average of 15.5 months. All fractures obtained healing with an average time of 14 weeks (ranged from 10 to 18 weeks). According to Mayo to assess the results, total score was 78.2±11.7, 2 cases got excellent results, 7 good, 1 fair, 1 poor. At final follow-up, the mean range of motion was (108±21)° in flexion, (12±8)° in extension, (66±13)° in pronation, (28±18)° in supination. The varus angle of the elbow ranged from 5°to 8° in 3 cases and the valgus angle was 8° in 1 case.

Conclusion: Treatment of the terrible triad of the elbow through medial and lateral approach can obtain satisfactory clinical effects, restore the elbow stability, allow early motion postoperatively, and promote the joint functional rehabilitation.
KEY WORDS  Elbow joint  Terrible triad of the elbow  Ulnar coronoid fracture  Radial head fracture
 
引用本文,请按以下格式著录参考文献:
中文格式:汪宇,庞广兴,张海滨,刘先银,黎松波.内外侧联合入路手术治疗肘关节三联征[J].中国骨伤,2016,29(7):662~664
英文格式:WANG Yu,PANG Guang-xing,ZHANG Hai-bin,LIU Xian-yin,LI Song-bo.Surgical treatment for terrible triad of the elbow through medial and lateral approach[J].zhongguo gu shang / China J Orthop Trauma ,2016,29(7):662~664
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