手术治疗肘关节恐怖三联征8例报告  

The Report of Outcome to Surgical Treatment of 8 Patients with the Terrible Triad of the Elbow

作　　者：周建刚[1] 孟维春[1] 曹骏敏[1] 钱玉强[1] 

机构地区：[1]江苏大学附属宜兴医院创伤骨科,江苏宜兴214200

出　　处：《中国临床医学》2011年第6期832-834,共3页Chinese Journal of Clinical Medicine

摘　　要：目的:回顾分析8例肘关节恐怖三联征的手术治疗过程和随访过程,加深对肘关节恐怖三联征概念的认识,并报告临床治疗体会。方法:2006年8月—2010年12月收治的肘关节恐怖三联征患者共8例。桡骨头骨折按Schatzker法分类Ⅰ型3例,Ⅱ型4例,Ⅲ型1例。尺骨冠状突骨折按O'Driscoll法分型Ⅰ型4例Ⅱ型4例。8例均行手术内固定,用2.0 mm双头加压螺钉及指骨小钛板固定尺骨冠状突和桡骨小头,并用空心带齿垫圈螺钉或锚钉修复内外侧副韧带。术后屈肘90°中立位石膏固定2周后拆除,开始肘关节屈伸和前臂旋转功能锻炼。结果:8例患者均获随访,随访时间5～24个月,骨折均愈合,关节稳定,其中1例发生骨化性肌炎,2例劳累后有轻微疼痛。根据Mayo肘关节功能评分:优6例(>90分),良1例(85分),可1例(65分)。结论:解剖复位、坚强可靠的内固定手术和适时的康复训练是治疗肘关节恐怖三联征的有效手段。Objective：To evaluate the clinical outcome of surgical treatment of 8 patients with the posterior dislocation of the elbow with coronoid and radial head fractures and improve the understanding of the concept of the terrible triad of the elbow. Methods：From August 2004 to December 2010,8 patients with terrible triad of the elbow were treated surgically.The radial head fractures were classified according to the Schatzker criteria,3 case in type 1,4 case in typeⅡand 1 case in typeⅢ.There were 4 cases of typeⅠ,4 cases of typeⅡand no case of typeⅢaccording to Regan-Morrey ulnar coronoid fracture classification. The fractured radial head and ulnar coronoid were fixed with Herbert screws and titanic mini-plate.The medial and lateral collateral ligaments were repaired with cannulated screws with toothed washer.The plaster was applied for two weeks postoperatively with elbow in 90 degrees of flexion and the forearm in neutral rotation.Motion of inflexion and extension of the elbow and forearm rotation began afterwards.Results：All the patients were followed up from 5 months to 24 months with bony healing and stable joint.One patient had heterotopic ossification.Two patients had mild pain after tiredness.According to the criteria of the Mayo scoring system,the results were excellent in 6 cases,good in 1 case and fair in 1 case.Conclusions：Adherence to the principles of anatomic reduction,stable internal fixation and appropriate functional exercise will significantly enhance the functional outcome of these patients with the terrible triad of the elbow injury.

关 键 词：手术 肘关节恐怖三联征 内固定 

分 类 号：R684.7[医药卫生—骨科学]