Yu James R, Throckmorton Thomas W, Bauer Rebecca M, Watson Jeffry T, Weikert Douglas R
Department of Orthopaedics and Rehabilitation, Vanderbilt University Medical Center, Nashville, TN 37232, USA.
J Shoulder Elbow Surg. 2007 Jan-Feb;16(1):60-7. doi: 10.1016/j.jse.2006.01.008.
We report the experience of a single surgeon who treated 20 patients, over a 9-year period, with acute complex instability of the elbow with hinged external fixation. Patients who presented greater than 6 months after the original injury were excluded. The mechanism of injury was typically a fall or a motor vehicle accident. Fixators were placed at a mean of 26 days (range, 0-66 days) after injury and initial management. Reconstruction of the collateral ligaments was not performed, but soft tissues were repaired en bloc to the humerus. All patients were available for follow-up at a mean of 2.1 years. Flexion-extension arcs averaged 93 degrees , whereas pronation-supination arcs averaged 96 degrees. Posttraumatic arthrosis was commonly seen at follow-up, with moderate or severe changes developing in 55% of patients. Arthrosis did not correlate with functional outcomes, however. Outcomes were measured by use of the Mayo Elbow Performance Index and the Hospital for Special Surgery Total Elbow Scoring System, with mean scores of 75 and 71 points, respectively. Although the severity of injury often precludes obtaining a high percentage of good and excellent results, the outcomes after treatment of acute complex elbow instability with hinged external fixation by use of the technique detailed in this series are comparable to those of similar series.
我们报告了一位外科医生在9年时间里使用铰链式外固定治疗20例急性肘关节复杂不稳定患者的经验。排除了在初次受伤6个月后就诊的患者。损伤机制通常为跌倒或机动车事故。受伤和初始处理后平均26天（范围0 - 66天）放置固定器。未进行侧副韧带重建，但将软组织整体修复至肱骨。所有患者均获随访，平均随访时间为2.1年。屈伸弧平均为93度，而旋前 - 旋后弧平均为96度。随访时常见创伤后关节病，55%的患者出现中度或重度改变。然而，关节病与功能结果无关。通过梅奥肘关节功能指数和特种外科医院全肘关节评分系统评估结果，平均得分分别为75分和71分。尽管损伤的严重程度常常使得难以获得高比例的良好和优秀结果，但使用本系列详述的技术通过铰链式外固定治疗急性肘关节复杂不稳定后的结果与类似系列相当。
