摘要
目的探讨后内侧不稳简单型肘关节脱位损伤机制,报告采用带线锚钉损伤韧带/肌腱-关节囊结构一期修复、早期保护性功能康复治疗的临床疗效。方法回顾性分析2012年1月至2014年6月,我院收治的15例后内侧不稳简单型肘关节脱位患者的病史资料。男11例,女4例,平均34（18-72）岁。病因：助动车事故12例,坠落伤2例,摔倒1例;术中采用带线锚钉行损伤韧带/肌腱-关节囊一期解剖修复,记录术中韧带、关节囊和肌腱损伤类别,明确软组织损伤与肘关节损伤体位、所受暴力的对应关系。术后支具保护下肘关节渐进性功能康复训练,定期门诊随访。结果内侧副韧带和前内侧关节囊撕脱损伤100%,屈肌肌腱60%、肱二头肌腱30%。肘关节损伤体位处于旋后伸直外展位;末次随访15例平均肘关节Mayo功能评分为93.2,尺神经损伤5例,异位骨化1例。结论肘关节伸直、旋后位受到轴向、过伸和外翻应力可能是后内侧不稳简单型肘关节脱位的损伤机制;后内侧不稳简单型肘关节脱位主要累及前内侧稳定结构,早期带线锚钉修复满意疗效。
Objective To investigate the injury mechanism of simple elbow dislocations with posteromedial instability, and to report the clinical results of the first-stage repair with wired anchor screws in injured ligament / tendon-capsule and early protected rehabilitation. Methods Data of 15 patients of simple elbow dislocations with posteromedical instability were reviewed by a retrospective analysis in our trauma center between January 2012 and June 2014. There were 11 males and 4 females with the mean age of 34 years（ range： 18- 72 years）. Causes： moped accident in 12 cases, falling injury in 2 cases, fall over in 1 case. Wired anchor screws were used intraoperatively in injured ligament / tendon-capsule anatomical repair at the first stage. Injury categories of the ligament, joint capsule and tendon were recorded. Relations between injuries of soft tissues and the elbow and correspondent violence were defined. Postoperative progressive functional rehabilitation training with the brace was conducted under the protection of the elbow. Regular outpatient follow-up was conducted. Results Avulsion injury was 100% for the medial collateral ligament and anteromedial capsule, 60% for the flexor tendon and 30% for the biceps tendon. The elbow injury occurred in supination, abduction and valgus position. In the latest follow-up, the overall mean Mayo Elbow Performance Score was 93.2, ulnar nerve injury occurred in 5 elbows, and heterotopic calcification was noted in 1 patient. Conclusions Elbow extension and supination under axial hyperextension and valgus stress is the injury mechanism of simple elbow dislocations with posteromedial instability. It mainly involves anteromedial stable structure. Early repair with wired screws can achieve satisfactory results.
出处
《中国骨与关节杂志》
CAS
2016年第4期256-260,共5页
Chinese Journal of Bone and Joint
关键词
肘关节
韧带
关节
腱损伤
创伤和损伤
软组织损伤
肘关节脱位
Elbow joint
Ligaments
articular
Tendon injuries
Wounds and injuries
Soft tissue injuries
Elbow dislocation
