金属人工桡骨头置换术治疗Essex-Lopresti损伤  

Treatment of Essex-Lopresti lesion with metallic radial head replacement

作　　者：芮碧宇[1] 夏荣刚[1] 吴佳俊[1] 丁坚[1] 章暐[1] 李晓林[1] 张长青[1] 曾炳芳[1] 

机构地区：[1]上海交通大学附属第六人民医院骨科,200233

出　　处：《国际骨科学杂志》2013年第3期213-216,共4页International Journal of Orthopaedics

摘　　要：目的随访并报告金属人工桡骨头置换治疗Essex-Lopresti损伤的临床疗效。方法 2009年1月至2011年11月间共有11例Essex-Lopresti损伤患者(Edwards-Jupiter分型Ⅰ型2例,Ⅱ型9例)在伤后3～7 d(平均4.5 d)接受金属人工桡骨头置换治疗,术后随访内容包括影像学检查、Mayo肘关节功能评分、改良Mayo腕关节功能评分,并记录并发症发生情况。结果 11例患者均获随访,平均19个月(12～37个月)。Mayo肘关节功能评分为平均82分(55～100分),其中优4例(36.4%),良5例(45.5%),可1例(9.1%),差1例(9.1%),优良率为81.8%;改良Mayo腕关节功能评分为平均92分(65～100分),其中优6例(54.5%),良4例(36.4%),可1例(9.1%),没有差的病例,优良率为91.0%。本组未见神经损伤、假体排异、切口感染等并发症。结论金属人工桡骨头假体置换治疗Essex-Lopresti损伤的临床效果满意,但手术设计和操作要精确。Objective To follow up and report the clinicai outcome of Essex-Lopresti lesion treatment with metallic radial head replacement. Methods In the period from January 2009 to November 2011, 11 patients of Essex-Lopresti lesions （ by Edwards-Jupiter classification, 2 cases were type I, and 9 cases type 11） were treated with metallic radial head replacement, which were performed 3 7 （mean 4. 5） days after injury. The follow up included radiologic examination, evaluation of elbow function by Mayo elbow performance index, and wrist by modified Mayo wrist performance index. The complications if any were recorded, as well. Results All the 11 patients in this series were followed up for a mean period of 19 months （12 37 months）. No elbow instabilities and distal radioulnar joint dislocation or/and subluxation were found in the radiologic evaluation. The Mayo elbow performance index was averaged 82 （55 100） points, indicating excellent in 4 cases, good in 5, mild in 1 and poor in l, with an overall excellent good rate being 81. 8%. The modified Mayo wrist performance index was averaged 92 （65 100） points, demonstrating excellent in 6 cases, good in 4 cases, mild in 1 and poor none, with an overall excellent good rate being 91.0%. No complications such as nerve damage, implant failure, wound infection, etc were noticed in the follow up. Conclusion The clinical outcome of the treatment of Essex-Lopresti lesion with metallic radial head replacement can be good while the preoperative plan and intraoperative performance should be accurate enough.

关 键 词：ESSEX-LOPRESTI损伤 桡骨头 假体置换 手术治疗 

分 类 号：R687.3[医药卫生—骨科学]