肘关节后外侧旋转不稳的诊断及治疗  

Diagnosis and treatment for posterolateral rotatory instability of the elbow

作　　者：康汇[1] 王微[1] 李红川[1] 李剑[1] 

机构地区：[1]西安交通大学附属红会医院运动医学肩肘病区,陕西西安710054

出　　处：《中国骨伤》2017年第11期1004-1007,共4页China Journal of Orthopaedics and Traumatology

摘　　要：目的:研究手术重建肘关节外侧韧带复合体治疗肘关节后外侧旋转不稳定的疗效。方法:收集2013年1月至2015年1月20例肘关节后外侧旋转不稳患者的资料,男12例,女8例;年龄30~60岁,平均45.5岁;右侧16例,左侧4例。9例有肘关节脱位史,6例有肘关节骨折史,5例无外伤史,所有患者为闭合性损伤。结合患者病史、查体及术前X线、MRI检查明确诊断。经保守治疗时间超过2个月无效,20例均在全麻下取患侧掌长肌腱作为重建移植物,行肘外侧韧带复合体的重建,术后根据患者情况进行个体化康复锻炼。结果:术后20例均获随访,未出现感染、肘关节功能明显受限等现象,平均随访16个月(12~23个月)。采用美国特种外科医院HSS评分标准和VAS评分标准对手术前后肘关节功能进行评分,术前HSS评分75.2±8.3,术后94.1±5.4;术前VAS评分6.7±3.2,术后2.3±1.5;术后评分均优于术前。结论:肘外侧韧带复合体是肘关节后外侧旋转不稳定的首要限制结构,重建肘外侧韧带复合体是治疗肘关节后外侧旋转不稳定的一种有效方法。Objective：To study the effects of surgical reconstruction of the lateral ligament complex for posterolateral rotatory instability（PLRI） of the elbow joint. Methods：From January 2013 to January 2015,20 patients with posterolateral rotatory instability of elbow joint were treated in our department. There were 12 males and 8 females whose age ranged from 30 to60 years old,with an average age of 45.5 years old. Sixteen patients had injuries on the right side and 4 patients had injuries on the left side. Nine patients were caused by elbow dislocation and 6 cases were caused by elbow fracture. Five patients had no history of trauma. All the patients had closed injuries. According to the patient＇s history,physical examination and preoperative X ray and MRI examination,a definite diagnosis was made. All the patients were treated conservatively for more than 2 months without efficacy,and they were treated with reconstruction of the lateral collateral ligament complex using palmaris longus tendon as a reconstruction graft under general anesthesia. Individual rehabilitation exercises were carried out according to the patient＇s condition. Results：All the patients were followed up,and the duration ranged from 12 to 23 months（mean,16 months）.There were no complications such as infection and obvious limitation of elbow joint. The HSS score of all the patients was improved from preoperative 75.2±8.3 to postoperative 94.1±5.4; and the VAS score was improved from preoperative 6.7±3.2 to postoperative 2.3 ±1.5. Conclusion：The lateral cubital ligament complex is the most important limiting structure for the posterolateral rotatory instability of the elbow joint. Reconstruction of the lateral ligament complex is an effective method for the treatment of posterolateral rotatory instability of the elbow joint.

关 键 词：肘关节 韧带 关节 创伤和损伤 

分 类 号：R684.7[医药卫生—骨科学]