手术治疗11例肘关节恐怖三联征合并尺骨鹰嘴骨折  

Surgical treatment for 11 cases of terrible triad of elbow associated with olecranon fracture

作　　者：刘平[1] 蔡培华[2] 孙文晓[1] 韦卓[1] 魏优秀[1] 姚弘毅[1] 杨盛力[3] 

机构地区：[1]华中科技大学同济医学院附属梨园医院骨科,湖北省武汉市430077 [2]上海交通大学附属第六人民医院 [3]香港中文大学研究生院外科学系

出　　处：《中国骨与关节损伤杂志》2013年第1期31-33,共3页Chinese Journal of Bone and Joint Injury

基　　金：湖北省自然科学基金项目(2010CDB07501);湖北省卫生厅青年基金(QJX2010-11)

摘　　要：目的探讨肘关节恐怖三联征合并尺骨鹰嘴骨折的手术方法和治疗效果。方法肘关节恐怖三联征合并尺骨鹰嘴骨折11例,尺骨冠突根据Regan-Morrey骨折分型:Ⅰ型5例,Ⅱ型4例,Ⅲ型2例。桡骨小头根据Hotchkiss改良的Mason骨折分型:均为Ⅳ型。尺骨鹰嘴骨折分类Colton(1973)Ⅰ型2例,Ⅱ型9例。外固定架于肘关节屈曲至90°固定,术后6～9 d开始行肘关节屈伸和前臂旋转的主动锻炼。结果本组获随访8～24个月,未出现骨折不愈合;肘关节屈曲-伸直活动范围平均在107.8°;前臂旋前-旋后活动范围平均为137.6°;肘关节按照Mayo标准评分:优3例,良5例,可3例,优良率72.7%。结论肘关节恐怖三联征合并尺骨鹰嘴骨折要求手术重建肘关节的稳定性,及时行功能康复锻炼,才能获得良好的关节功能。Objective To evaluate the method of treatment for terrible triad of the elbow associated with olecranon fracture. Methods From November 2005 to September 2009 eleven cases were diagnosed as terrible triad of the elbow associated with olecranon fracture. According to Regan-Morrey classification of olecranon fracture, type Ⅰ 5 cases; type Ⅱ 4cases; type Ⅲ 2 cases; The radial head fractures according to Johnston-Mason classification, type Ⅳ 11 cases; According to Cohon （1973） classification of olecranon fracture, type Ⅰ 2 cases; type Ⅱ 9 cases. External fixators were fixed in position with elbow flexion at 90° and forearm rotation in neutral. After 6～9 days physical exercise started. Results All patients were followed-up from 8 to 24 months with hea led fractures The total range of elbow flexion-extension was 107.8° and forearm rotation was 137.6°. The clinical results were evaluated according to Mayo elbow performance score, excellent 3 patients, good 5 patients, 2 fair and 1 poor;, the excellent and good rate was 72.7%. Conclusion Terrible triad of the elbow associated with oleeranon fracture can have chance of better functional outcome with reconstruction of joint and soft tissue structural stability and early rehabilitation exercises.

关 键 词：恐怖三联征 尺骨鹰嘴骨折 内固定 外固定架 重建 

分 类 号：R683.41[医药卫生—骨科学]