摘要
目的:分析不同类型金属钉置入内固定肘关节恐怖三联征患者解剖结构以及力学稳定性的关系。方法:于2007-06/2009-03共收治肘关节恐怖三联征患者8例,其中尺骨冠突骨折按Regan-Morrey法分类:Ⅰ型2例,Ⅱ型5例,Ⅲ型1例;桡骨头骨折按Mason法分类:Ⅰ型1例,Ⅱ型6例,Ⅲ型1例。8例患者均采取了内固定治疗,采用中空拉力螺钉或Herbert螺钉固定冠突和桡骨头骨折,修补环状韧带,1例缝合修复肘外侧副韧带,术后屈肘90°旋前中立位,以塑形良好的高分子管型石膏固定两三周后开始屈伸和旋转康复训练。结果:对8例患者进行了5～27个月的随访,平均15个月。所有病例均获得了肘关节稳定的中心性复位,获得骨性愈合,Mayo肘关节功能评分:优3例,良3例,可1例,差1例,优良率75%。结论:肘关节恐怖三联征只有在重建骨关节和软组织结构稳定的基础上,及早进行功能锻炼,才能获得较好的功能恢复,但远期疗效还有待于进一步病例积累和随访评估。
OBJECTIVE： To explore the relationship between anatomical structure and mechanical stability in patients with “terrible triad of the elbow” by different metal screw implantation fixation. METHODS： From June 2007 to March 2009, 8 patients with terrible triad of the elbow were treated. The fracture of the radial head was classified according to the system of Mason, with type r in 1 patients, type 11 in 6 and type 111 in 1; fracture of the coronoid process was classified according to the system of Regan and Morrey, with type I in 2 patients, type I~ in 5, and type III in 1. The hollow lag screws and Herbert screws were used to flxe coronoid process and radial head fractures, and repair Annular ligament. Lateral collateral ligament was repaired in 1 case. All injured extremities were treated with a posterior plaster splint with the elbow joint held in 90~ of flexion and the forearm in neutral rotation for 2 3 weeks followed by elbow rehabilitation training. RESULTS： All 8 patients were followed up for an average 15 months （range 5 to 27 months）. A reduced and stable elbow joint were achieved in all patients. The clinical results were evaluated according to Mayo elbow performance score, with 3 patients were rated as excellent, 3 good, 1 fair and 1 poor; the excellent and good rate was 75%. CONCLUSION： Better functional outcome can be achieved only within the reconstruction of joint and soft tissue structural stability as well as early rehabilitation exercises. However, long-term effect requires the accumulation of cases and long time follow-up.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第43期8568-8572,共5页
Journal of Clinical Rehabilitative Tissue Engineering Research
