摘要
背景:尺骨鹰嘴骨折-脱位为复杂肘关节骨折脱位之一,给临床诊疗增加一定的挑战性。虽然不断提升的医疗水平使尺骨鹰嘴骨折-脱位的临床诊疗得到了一定发展,但也存在一些争议问题需要进一步探讨。目的:查阅和整理关于尺骨鹰嘴骨折-脱位临床诊疗研究的相关文献,并进行总结。方法:第一作者检索Web of Science、PubMed和中国知网(CNKI)数据库2000至2020年收录的相关文献,中英文检索词分别为"鹰嘴,肘关节,骨折脱位,3D打印"和"olecranon,elbow,fracture dislocation,3D printing"。查阅收集大量文献,从解剖力学、损伤特点、诊断分型和手术治疗等方面分类整理和分析。结果与结论:①鹰嘴、冠状突、桡骨头的解剖形态以及软组织之间的解剖力学特点影响着尺骨鹰嘴骨折-脱位的临床诊疗;②前、后脱位均有其自身损伤特点,同时易与孟氏骨折相混淆,准确把握体格检查与辅助影像检查有利于临床诊断;③手术入路中仍以后正中入路更为常用,必要时需联合其他入路;恰当固定修复骨与软组织,以及适时的辅助外固定架,均有利于改善尺骨鹰嘴骨折-脱位的临床疗效;④但是后方尺骨鹰嘴骨折-脱位的损伤机制还需更深层次探究,以及是否建立尺骨鹰嘴骨折-脱位独立分型尚需进一步讨论;鹰嘴后方间接固定冠状突的有效性问题,仍需进一步深入研究;⑤此外,兴起的3D打印技术对骨创伤术前规划和模拟操作具有重要意义,将会更有利于尺骨鹰嘴骨折-脱位临床诊疗工作的开展。
BACKGROUND:Olecranon fracture-dislocations are complicated fractures and dislocations of the elbow,which adds certain challenges to clinical diagnosis and treatment.Although the continuous improvement of medical standards has made some progress in the clinical diagnosis and treatment of olecranon fracturedislocations,some controversial issues need to further discuss.OBJECTIVE:To consult and sort out the relevant literature about the clinical diagnosis and treatment of olecranon fracture-dislocations,and give a summary.METHODS:The first author searched the relevant documents collected by Web of Science,PubMed and CNKI databases from 2000 to 2020.The key words were"olecranon;elbow;fracture dislocation;3D printing"in English and Chinese.The massive relevant literature was reviewed and collected.The literature was classified and analyzed from the aspects of anatomical mechanics,injury characteristics,diagnostic typing and surgical treatment.RESULTS AND CONCLUSION:(1)The anatomy of the olecranon,coronoid process,radial head,and the anatomical mechanical characteristics between the soft tissues affect the clinical diagnosis and treatment of olecranon fracture-dislocations.(2)Both anterior and posterior dislocations have their own injury characteristics and are easily confused with Monteggia fractures.Accurate grasp of physical examination and auxiliary imaging examination is conducive to clinical diagnosis.(3)The posterior midline approach is more commonly used,and other approaches should be combined if necessary.Proper fixation and repair of bone and soft tissue,as well as timely auxiliary external fixator,are conducive to improving the clinical efficacy of olecranon fracture-dislocations.(4)However,the damage mechanism of the rear olecranon fracture-dislocations needs to be further explored,and whether to establish independent classification of olecranon fracture-dislocations needs further discussion.The effectiveness of the indirect fixation of the coronoid process behind the olecranon still needs further research.(
作者
王德斌
毕郑刚
Wang Debin;Bi Zhenggang(Department of Orthopedics,First Affiliated Hospital of Harbin Medical University,Harbin 150001,Heilongjiang Province,China)
出处
《中国组织工程研究》
CAS
北大核心
2021年第9期1446-1451,共6页
Chinese Journal of Tissue Engineering Research
关键词
骨
尺骨鹰嘴
骨折
脱位
解剖力学
固定
3D打印
综述
bone
olecranon
fracture
dislocation
anatomy mechanics
fixation
three-dimensional printing
review
