后外侧入路联合前内侧入路治疗肘关节恐怖三联症的疗效分析

发布时间：2018-12-30 12:55

【摘要】：目的探讨后外侧入路联合前内侧入路治疗肘关节恐怖三联征的临床效果。方法选取我院2014年10月—2016年10月,采用后外侧入路联合前内侧入路治疗肘关节恐怖三联征患者18例。其中男14例,女4例;年龄22~56岁,平均40.75岁。左侧5例,右侧13例。桡骨头骨折均以Hotchkiss改良的Mason分类法分类,均为Ⅳ型;尺骨冠状突骨折以Regan-Morrey分类法分类:其中I型11例,Ⅱ型4例,Ⅲ型3例。受伤至手术时间1d~17d不等,平均为6d。术后随访,观察并统计骨折愈合、软组织修复、术后并发症、肘关节评分及功能改善情况。结果本研究中的18例患者,均获6-30个月随访,平均12.3个月。术前患者肘关节活动度:屈伸(63.5°±7.2°),前臂旋转(73.5°±8.4°)。全部患者术后复查X线片均显示骨折愈合,时间为8~13周,平均10.4周。均无术后感染及肘关节不稳发生。末次随访时肘关节活动度为:屈伸(115.25°±9.6°),前臂旋转(124.625°±12.03°)。末次随访MEPS评分结果:优10例,良6例,可2例,无功能评分为差。与术前比较,差异有统计学意义(P0.05)。与健侧相比屈伸(119±11.67°),旋转(128.25±10.29°),差异没有统计学意义(P0.05)。结论后外侧入路联合前内侧入路治疗肘关节恐怖三联征,可恢复其骨与软组织,使骨折愈合良好,明显改善肘关节稳定性,很大程度上改善其活动度,早期可行无痛(在镇痛泵下)肘关节功能锻炼,满足日常活动需求,疗效满意;此入路操作安全简便,术区视野广,暴露清楚,直视下操作更精细,便于复位与内固定,且不易损伤血管及神经,并能减少软组织剥离,术后并发症少,恢复良好。是临床治疗肘关节恐怖三联征的有效手术方法,对临床治疗该类疾病具有指导意义。
[Abstract]:Objective to investigate the clinical effect of posterolateral approach combined with anterior medial approach in the treatment of triple elbow joint terror syndrome. Methods from October 2014 to October 2016, 18 cases of elbow terror triple sign were treated with posterolateral approach and anterior medial approach. Among them, 14 cases were male and 4 cases were female, the age was 2256 years old with an average of 40.75 years old. Left 5 cases, right 13 cases. The radial head fractures were classified by Hotchkiss's improved Mason classification, and the ulna coronal process fractures were classified by Regan-Morrey 's classification: 11 cases were type I, 4 cases were type 鈪，

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