可吸收缝线辅助固定治疗肘关节软骨骨折  

Treatment of elbow joint cartilage fracture with absorbable suture assisted fixation

作　　者：王欢 邢丹谋[1] 任东 冯伟 陈焱 张明 吴其鹏 Wang Huan;Xing Danmou;Ren Dong;Feng Wei;Chen Yan;Zhang Ming;Wu Qipeng(Hand Microsurgery and Reconstruction Center,Wuhan Fourth Hospital,Wuhan Orthopedic Hospital,Wuhan 430030,China)

机构地区：[1]武汉市第四医院、武汉市骨科医院手显微及修复重建外科中心,武汉430030

出　　处：《中华手外科杂志》2023年第5期388-391,共4页Chinese Journal of Hand Surgery

基　　金：2019年武汉市医学科研项目(武卫通[2019]88WX19Y19)。

摘　　要：目的报告可吸收缝线辅助缝合固定治疗肘关节软骨骨折的临床疗效。方法回顾性分析自2016年6月至2021年3月收治的21例肘关节软骨骨折患者的临床资料, 其中肘关节脱位伴肱骨内髁骨折桡骨小头骨折1例, 桡骨小头骨折伴软骨部分游离6例, 桡骨小头骨折伴肱骨小头骨折6例, 肱骨远端关节内骨折3例, 肘关节脱位伴桡骨小头尺骨冠突骨折4例, 尺骨鹰嘴桡骨小头尺骨冠突骨折1例。所有患者均在术中使用可吸收缝线进行缝合辅助固定关节软骨骨折块。术后根据Broberg-Morrey肘关节功能评分标准评价肘关节功能, 记录肘关节的屈伸活动度及前臂旋转活动度。结果术后所有患者均获得随访, 时间为13~64个月, 平均23个月。1例因关节周围异位骨化形成二期行关节松解手术;1例内侧副韧带钙化, 肘关节僵硬。末次随访时患侧肘关节平均屈曲119.8°(90°~140°), 伸直-3.8°(-45°~0°);前臂旋前78.3°(46°~84°), 旋后79.6°(62°~87°)。肘关节Broberg-Morrey评分为59~95分, 平均91.2分;优12例, 良8例, 差1例。结论通过缝合固定技术修复肘关节软骨骨折, 可最大程度保留关节软骨完整性, 早期行关节功能锻炼, 疗效满意。Objective To report the clinical efficacy of absorbable suture assisted fixation in the treatment of elbow joint cartilage fractures.Methods The clinical data of 21 patients with cartilage fractures of the elbow joint admitted from June 2016 to March 2021 were retrospectively analyzed,including 1 case of dislocation of the elbow joint with fracture of the medial condyle of humerus and radial capitulum,6 cases of fracture of the radial capitulum with partial cartilage detachment,6 cases of fracture of the radial capitulum with fracture of the capitulum of humerus,3 cases of intra-articular fracture of the distal humerus,and 4 cases of dislocation of the elbow joint with fracture of the ulna coronoid process and the radial capitulum,1 case of fracture of ulna olecranon,radial capitulum and ulna coronoid process.All the patients were conducted by absorbable sutures to assist in the fixation of articular cartilage fracture blocks during surgery.After surgery,the elbow function was evaluated according to the Broberg-Morrey elbow function scoring standard,and the elbow flexion and extension activity and forearm rotation activity were recorded.Results All the patients were follow-up from 13 to 64 months with an average of 23 months.One patient underwent secondary arthrolysis due to ectopic ossification around the joint.One case had calcification of the medial collateral ligament and stiffness of the elbow joint.At the last follow-up,the average flexion of the affected elbow joint was 119.8°(90°to 140°),and the extension was-3.8°(-45°to 0°).The forearm pronation averaged 78.3°(46°to 84°)and supination averaged 79.6°(62°to 87°).The Broberg-Morrey score of the elbow joint was 59 to 95 points,with an average of 91.2 points.There were 12 excellent cases,8 good cases,and 1 poor case.Conclusion The repair of elbow joint cartilage fractures with suture fixation technology can maximize the preservation of articular cartilage integrity,and early joint functional exercise can achieve satisfactory results.

关 键 词：软骨 骨折 肘关节 缝合固定 

分 类 号：R687.3[医药卫生—骨科学]