肘关节外侧尺骨韧带重建或修复手术治疗后外侧旋转不稳的初步结果  

Preliminary report on lateral ulnar collateral ligament reconstruction or repair for treatment of posterolateral rotatory instability of elbow

作　　者：闫辉[1] 崔国庆[1] 刘玉雷[1] 肖健[1] 敖英芳[1] 

机构地区：[1]北京大学第三医院运动医学研究所,100191

出　　处：《中华医学杂志》2011年第23期1595-1599,共5页National Medical Journal of China

摘　　要：目的 探讨肘关节外侧尺骨韧带重建或修复手术治疗后外侧旋转不稳的初步临床效果.方法 2006年12月至2010年9月连续收治肘关节后外侧旋转不稳患者9例（9个肘）,其中6例患者进行掌长肌腱移植外侧尺骨韧带重建术,另3例患者进行外侧尺骨韧带修复术.手术时患者平均年龄28岁（17～48岁）.9例患者均有肘外伤史,其中6例为肘脱位伤.术前症状持续时间平均为10.7个月（0.2～30个月）.根据Nestor评估方法评价患者术后效果.结果 9例患者均获随访,平均随访20个月（4～49个月）.9例患者均无肘关节不稳症状,肘关节轴移试验均为阴性.Nestor评估结果：优6例,良2例,中1例.6例患者对手术效果表示非常满意、3例满意,无不满意患者.结论 肘关节后外侧旋转不稳的正确诊断对于适当的治疗非常重要.根据肘关节外侧尺骨韧带的质量,选择进行外侧尺骨韧带重建或修复手术,可以很好的恢复肘关节稳定性和功能.Objective To explore the preliminary results of lateral ulnar collateral ligament （LUCL） reconstruction or repair for posterolateral rotatory instability （PLRI） of elbow.Methods Between December 2006 and September 2010, 9 consecutive patients （9 elbows） undergoing surgical reconstruction or repair of LUCL for the treatment of elbow PLRI were studied.Surgical reconstruction of LUCL was performed with a tendon graft in 6 elbows and reattachment of LUCL to humerus in 3.The mean patient age was 28 years （range： 17-48）. All patients had a previous history of elbow injury.Among them, 6 had a history of elbow dislocation.The average duration of symptoms was 10.7 months （range：5 days-30 months）.The outcomes were graded with respects to objective and subjective stability, pain and range of motion as defined by Nestor.Results All patients were followed up.The mean follow-up period was 20 months （range：4-49）. Postoperatively, no patient had residual instability or a positive pivot shift test in elbow.Their outcomes were graded as excellent （n=6）, good （n=2） and fair （n=1）.Subjective assessment revealed that all were satisfied with their surgical outcomes.Conclusion An accurate recognition of PLRI of elbow is important for its appropriate management. Tendon graft is recommended for the reconstruction of LUCL.Surgical ligament reconstruction or repair is the preferred treatment option for restoring normal functions and elbow stability.Further studies are warranted because of a limited number of patients in the present study.

关 键 词：修复外科手术 韧带 尺骨 

分 类 号：R687.3[医药卫生—骨科学]