可调外固定支具和铰链外固定架治疗肘关节恐怖三联征的比较  

Efficacy of adjustable external support versus hinged external fixator in the treatment of terrible triad of elbow

作　　者：胡攀勇 杨绍安[1] 蔡保塔[1] 曹军[1] 杨潇[1] Hu Panyong;Yang Shaoan;Cai Baota;Cao Jun;Yang Xiao(Department of Traumatic Orthopedics,Zhujiang Hospital of Southern Medical University,Guangzhou 510280,Guangdong Province,China)

机构地区：[1]南方医科大学珠江医院创伤骨科,广东省广州市510280

出　　处：《中国组织工程研究》2018年第35期5607-5613,共7页Chinese Journal of Tissue Engineering Research

基　　金：广州市海珠区科普计划项目(2014HZKP-TJ-12)~~

摘　　要：背景:目前治疗肘关节恐怖三联征术后常发生肘关节不稳、僵硬、内外翻等并发症,关节活动功能不佳,为提高治疗效果和生活质量,术后需联合有效外固定进行早期功能锻炼,加速肘关节功能恢复,预防并发症发生。目的:对比研究可调外固定支具和铰链外固定架治疗肘关节恐怖三联征的疗效。方法:回顾性分析2013年1月至2017年1月南方医科大学珠江医院收治的65例肘关节恐怖三联征患者,采用肘关节内外侧联合入路行桡骨头、冠状突骨折切开复位内固定及侧副韧带修复手术,按外固定类型不同分为2组,可调组术后联合可调外固定支具30例,铰链组术后采用铰链外固定架35例。随访1年后评估肘关节屈伸活动度、前臂旋转范围、骨折愈合时间及Mayo评分评估肘关节功能。结果与结论:(1)可调组:肘关节屈伸活动度平均(123.3±6.4)°,前臂旋转范围平均(133.9±6.4)°;骨折愈合时间平均(12.3±1.9)周;Mayo评分优28例,良2例;2例出现肘关节异位骨化,1例肘关节外翻畸形愈合;(2)铰链组:肘关节屈伸活动度平均(125.5±6.4)°,前臂旋转范围平均(133.1±6.5)°;骨折愈合时间平均(12.0±1.9)周;Mayo评分优34例,良1例;1例出现旋转中心偏移,1例出现针道感染;(3)2组术后肘关节屈伸活动度、前臂旋转范围、骨愈合时间及Mayo评分差异无明显著性意义(P> 0.05);(4)综上说明,可调外固定支具和铰链外固定架治疗肘关节恐怖三联征在肘关节屈伸活动度、前臂旋转角度、骨折愈合时间及Mayo评分具有相似结果,可调外固定支具在一定条件下可替代铰链外固定架。BACKGROUND:Complications such as instability,stiffness and malunion of elbow joint often occur in terrible triad of elbow after surgery and movement function of the joint is poor.In order to improve the therapeutic effect and the quality of life,it is necessary to perform functional training in the early stage of combined effective external fixation,accelerate the recovery of the elbow joint function and prevent the complications.OBJECTIVE:To compare the efficacy of hinged external fixator and external fixator in the treatment of terrible triad of elbow joint.METHODS:Sixty-five patients with the“terrible triad of the elbow”admitted in the Zhujiang Hospital of Southern Medical University from January 2013 to January 2017 were analyzed retrospectively.The operation was performed combined with lateral and medial surgery approaches of the elbow joint for the open reduction and fixation of the capitulum radial and coronoid fracture,and repair of the collateral ligament.According to external fixation after surgery,patients were divided into two groups.Support group:30 patients were treated with adjustable external support after surgery.Fixator group:35 patients received hinged external fixator after surgery.The range of elbow flexion-extension,forearm pronation-supination range,healing time,and Mayo scores after 1-year follow up were detected.RESULTS AND CONCLUSION:(1)Support group:the mean range of elbow flexion-extension was(123.3±6.4)°,mean forearm pronation-supination range was(133.9±6.4)°,and the mean healing time was(12.3±1.9)weeks.According to Mayo scores,there were excellent in 28 cases,and good in 2 cases.Two cases appeared with heterotopic ossification of the elbow,and one case had articular valgus deformity healing.(2)Fixator group:the mean range of elbow flexion-extension was(125.5±6.4)°,mean forearm pronation-supination range was(133.1±6.5)°,and the mean healing time was(12.0±1.9)weeks.According to Mayo scores,there were excellent in 34 cases,and good in 1 case.One case appeared with heteroto

关 键 词：肘关节恐怖三联征 可调外固定支具 铰链外固定架 早期康复 骨折内固定 临床研究 肘关节 骨折 外固定器 康复 组织工程 

分 类 号：R459.9[医药卫生—治疗学]