外侧入路联合前内侧入路治疗肘关节“恐怖三联征”的临床探究  

Clinical study of lateral approach combined with anteromedial approach in the treatment of “terrible triad” of elbow joint

作　　者：张志文[1] 黄玉良[1] 丘龙海 王晓锋[1] Zhang Zhiwen;Huang Yuliang;Qiu Longhai;Wang Xiaofeng(Department of Traumatic Orthopedics,Huizhou Central People’s Hospital,Huizhou 516001,Guangdong,China)

机构地区：[1]广东省惠州市中心人民医院创伤骨科

出　　处：《右江民族医学院学报》2019年第5期551-553,556,共4页Journal of Youjiang Medical University for Nationalities

基　　金：广东省惠州市科技计划项目(19041714573231)

摘　　要：目的探究肘关节“恐怖三联征”临床治疗中应用外侧入路联合前内侧入路治疗的效果。方法纳入我院收治的40例肘关节“恐怖三联征”患者作为研究对象,均给予外侧入路联合前内侧入路手术治疗,对其临床治疗效果进行观察分析。结果观察临床相关指标发现,术中出血量为(439.61±25.67)ml,手术时间为(71.98±5.08)min,住院时间为(9.34±1.04)d,均属于较优指标。观察术前术后的MEPS评分发现,术后3个月(59.97±1.05)分、6个月(73.61±2.14)分和12个月(89.64±5.01)分的评分均高于术前的(42.28±2.32)分,术后6个月高于术后3个月,术后12个月高于术后6个月,两两比较差异具有统计学意义(P<0.001)。观察术后并发症情况发现,无患者出现伤口表浅感染、术后尺神经症状、骨折不愈合、骨折畸形愈合等并发症,发生率为0.00%,属于较低指标。结论外侧入路联合前内侧入路治疗肘关节“恐怖三联征”的临床效果显著,可有效地改善患者的肘关节功能,出血量少、手术时间和住院时间短,且术后并发症少,可见其临床治疗有效性和安全性均较高,具有较高临床应用价值。Objective To explore the effect of applying lateral approach combined with anteromedial approach in the clinical treatment of“terrible triad”of elbow joint.Methods The 40 patients admitted to our hospital with“terrible triad”of elbow joint were selected as the study subjects.All patients underwent surgery by lateral approach combined with the anteromedial approach,and the clinical effect was observed and analyzed.Results The relevant clinical indicators showed that the intraoperative blood loss was(439.61±25.67)ml,the operation time was(71.98±5.08)min,and the duration of hospitalization was(9.34±1.04)d,all of which were better indicators.After observation of preoperative and postoperative MEPS scores,it was found that the scores at the third month after surgery were(59.97±1.05)points,the sixth month after surgery were(73.61±2.14)points and the twelfth month after surgery were(89.64±5.01)points,all of which were higher than the preoperative score of(42.28±2.32)points.The scores at the sixth month after the operation were higher than those at the third month after the operation,and the scores at the twelfth month after the operation were all higher than those at the sixth month after the operation,pairwise comparison showed statistically significant differences(P<0.001).After observation of postoperative complications,it was found that no patients had superficial wound infection,postoperative ulnar nerve symptoms,fracture nonunion,fracture malunion and other complications,and the incidence was 0.00%,which was a low index.Conclusion The lateral approach combined with anteromedial approach for the treatment of“terrible triad”of the elbow joint has a good clinical effect.It can effectively improve the elbow joint function of the patients with less bleeding,shorter operation time and duration of hospitalization and fewer postoperative complications.It can be seen that its clinical treatment effectiveness and safety are both high,and it has high clinical application value.

关 键 词：外侧入路 前内侧入路 联合治疗 肘关节 恐怖三联征 

分 类 号：R687[医药卫生—骨科学]