前正中入路联合外侧入路治疗肘关节恐怖三联征的效果评价  

Evaluation of the effect of anterior median approach combined with lateral approach in the treatment of terrible triad of the elbow

作　　者：李源力 蔚芃[1] 邓春彪 聂君兰 杨鑫[1] 蒋萍[1] LI Yuanli;WEI Peng;DENG Chunbiao;NIE Junlan;YANG Xin;JIANG Ping(Department of Orthopaedics,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 643000,P.R.China)

机构地区：[1]川北医学院附属医院骨科,四川南充643000

出　　处：《华西医学》2020年第10期1185-1188,共4页West China Medical Journal

摘　　要：目的探讨肘关节前正中入路联合外侧入路治疗肘关节恐怖三联征的临床意义。方法回顾性收集2014年3月—2019年7月63例采用肘关节前正中入路联合外侧入路(A组,n=36)或肘关节内、外侧入路(B组,n=27)治疗的肘关节恐怖三联征患者资料,比较两种手术入路患者手术时间、术后并发症及术后肘关节Mayo评分。结果A组与B组手术时间分别为(93.78±7.78)、(106.93±10.35)min,差异有统计学意义(P<0.05)。两组患者术中、术后均无血管、神经损伤,术后伤口Ⅰ期愈合,所有患者未出现再脱位以及重新手术。术后随访10个月,A组与B组Mayo评分优良率分别为83.3%和85.2%,术后并发症发生率分别为16.7%和14.8%,差异均无统计学意义(P>0.05)。结论肘关节前正中入路联合外侧入路和肘关节内、外侧入路治疗肘关节恐怖三联征患者术后肘关节功能恢复情况无明显差异,前者手术时间比后者短,前侧入路显露冠突直观、充分,在明确没有内侧韧带损伤的情况下,可优先选择肘关节前正中入路联合外侧入路。Objective To explore the clinical significance of anterior median approach combined with lateral approach to the elbow joint in the treatment of terrible triad of the elbow.Methods We retrospectively collected the data of 63 cases who used the anterior median approach of the elbow joint combined with the lateral approach(group A,n=36)or the medial and lateral approach of the elbow(group B,n=27)in the treatment of terrible triad of the elbow between March 2014 and July 2019.The operation time,postoperative complications,and postoperative Mayo score of the elbow were compared between the two surgical approaches.Results The operation time of group A and group B was(93.78±7.78)and(106.93±10.35)min,respectively,and the difference was statistically significant(P<0.05).The patients in both groups completed operations successfully,without vascular or nerve injury.All the wounds healed by first intention.No redislocation or reoperation occurred.Ten months after operation,there was no significant difference in the excellence rate of Mayo score of the elbow(83.3%vs.85.2%)or postoperative complication rate(16.7%vs.14.8%)between the two groups(P>0.05).Conclusion The anterior median approach of the elbow joint combined with the lateral approach and the medial and lateral elbow approach for the treatment of terrible triad of the elbow are equivalent to the postoperative elbow function recovery.The operation time of the former is shorter than that of the latter,and the anterior approach reveals the coronal process intuitively and sufficiently.In the case that there is no medial ligament injury,the anterior median approach of the elbow joint combined with the lateral approach can be preferred.

关 键 词：肘关节前正中入路联合外侧入路 肘关节内、外侧入路 肘关节恐怖三联征 桡骨头骨折 冠突骨折 

分 类 号：R687.4[医药卫生—骨科学]