铰链式外固定支架联合侧副韧带重建治疗外伤性陈旧性肘关节脱位  

Treatment of chronically unreduced elbow dislocation with collateral ligament reconstruction and hinged external fixation

作　　者：刘小源 易成腊[2] 孙云[2] 蒋猛[2] 卢光辉 

机构地区：[1]大冶市人民医院骨科,湖北黄石435100 [2]华中科技大学同济医学院附属同济医院创伤外科,湖北武汉430030

出　　处：《生物骨科材料与临床研究》2013年第6期16-19,共4页Orthopaedic Biomechanics Materials and Clinical Study

摘　　要：目的 探讨铰链式外固定支架联合侧副韧带重建治疗陈日性肘关节骨折脱位手术方法和临床疗效.方法 2005年6月～2012年8月,对6例外伤性陈旧性肘关节脱位采用铰链式外固定支架联合掌长肌腱移植重建侧副韧带进行治疗,其中男4例,女2例.平均年龄36.5 (20～52)岁.脱位类型:后脱位3例,后外侧脱位3例.患者初次受伤至接受手术时间平均为42天(30～63天).术后连续随访并采用Mayo评分对肘关节功能进行评价及评级.结果 6例患者经过6～18个月的随访,平均肘关节屈曲118.5°,Mayo评分平均86分(62～96分),其中优2例,良3例,中l例,1例合并轻度异位骨化,1例合并针道感染.结论 对于陈旧性肘关节脱位,行侧副韧带重建术后可常规应用铰链式外固定支架辅助治疗,外固定支架固定允许术后早期功能锻炼,可减少关节僵硬、异位骨化等并发症,能很好的维持手术效果,获得满意的复位和功能.Objective To explore the results of operative treatment of chronically unreduced elbow dislocation with hinged external fixation and reconstruction of the ligament. Methods Between June 2005 and August 2012, 6 patients(6 elbows) were undergone surgical reconstruction of collateral ligament combined with external fixator. There were 4 men and 2 women, and the mean patient age was 36.5 years(range 20 to 52). All of the cases were chronically unreduced elbow dislocations. The average duration from injury to operation was 42 days(range 30 to 63 days). The treatment options includes reconstruction of collateral ligament and application of an external fixator. 3 days after the procedure the active mobilization was introduced. The performance of the elbow was evaluated with the Mayo Elbow Performance Index. Results All patients were followed up. The mean follow-up period was 10.2 months(range 6 to 18months). The average arc of motion was 118.5 degrees and average scores on the Mayo Elbow Performance Index was 86 points, with 2 excellent, 3 good and 1 fair outcomes. Ectopic bone formation occurs in 1 patients. But no restriction of the flexion happened. 1 infection related to the pin and no nerve injured. Conclusion For the chronically unreduced elbow dislocation, surgeon applied an external fixator regularly after the reconstruction of the collateral ligament. It allowed early motion exercises and reducing the risk of joint stiffness, fibrosis and ectopic bone formation while protecting the bony and soft tissue structures involved in the reconstruction.

关 键 词：陈旧性肘关节脱位 铰链式外固定支架 掌长肌腱 侧副韧带重建 

分 类 号：R687.4[医药卫生—骨科学]