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DANE TJ技术治疗肘关节尺侧副韧带损伤的临床疗效

Clinical outcomes of the DANE TJ technique to treat ulnar collateral ligament insufficiency of the elbow.

作者信息

Dines Joshua S, ElAttrache Neal S, Conway John E, Smith Wade, Ahmad Christopher S

机构信息

Kerlan Jobe Orthopaedic Clinic, 6801 Park Terrace, Los Angeles, CA 90045, USA.

出版信息

Am J Sports Med. 2007 Dec;35(12):2039-44. doi: 10.1177/0363546507305802. Epub 2007 Aug 16.

Abstract

BACKGROUND

Many improvements in ulnar collateral ligament reconstruction have been made since Jobe et al first described the procedure. A novel elbow ulnar collateral ligament reconstruction technique that combines interference screw fixation on the ulna with docking of the graft on the humeral side (DANE TJ) has been reported.

HYPOTHESIS

Outcomes of ulnar collateral ligament reconstructions performed with the DANE TJ technique are as good as other recently published results of ulnar collateral ligament reconstruction, particularly in cases of insufficient bone stock on the sublime tubercle and revision reconstructions.

STUDY DESIGN

Case series; Level of evidence, 4.

METHODS

During a 3-year period, 22 athletes were treated with surgical reconstruction of the ulnar collateral ligament using proximal docking and distal interference screw fixation of the ligament (DANE TJ technique). All patients had a history, physical examination findings, and magnetic resonance imaging results consistent with ulnar collateral ligament injury. Patients were evaluated at a mean of 36 months postoperatively. Outcomes were classified using a modified Conway Scale.

RESULTS

At the most recent follow-up, 19 of 22 patients had excellent results. There were 2 fair results and 1 poor result. The poor result was in a revision case. The 2 other revision ulnar collateral ligament reconstructions had excellent outcomes. When used in 2 cases of sublime tubercle avulsions, the results were excellent. Postoperative complications occurred in 4 patients: 2 developed ulnar neuritis, and 2 required second surgeries for lysis of adhesions. Three of these 4 patients went on to have excellent outcomes.

CONCLUSION

Clinically, the initial results compare favorably with other published techniques of elbow ulnar collateral ligament reconstruction. These early data support the use of the DANE TJ technique for revision cases and cases of sublime tubercle insufficiency.

摘要

背景

自乔布等人首次描述尺侧副韧带重建手术以来,该手术已有许多改进。据报道,一种新颖的肘关节尺侧副韧带重建技术,即将尺骨上的干涉螺钉固定与肱骨侧移植物对接相结合(DANE TJ)。

假设

采用DANE TJ技术进行尺侧副韧带重建的结果与最近发表的其他尺侧副韧带重建结果一样好,特别是在滑车结节骨量不足和翻修重建的病例中。

研究设计

病例系列;证据等级,4级。

方法

在3年期间,对22名运动员进行了尺侧副韧带手术重建,采用韧带近端对接和远端干涉螺钉固定(DANE TJ技术)。所有患者的病史、体格检查结果和磁共振成像结果均与尺侧副韧带损伤相符。患者平均在术后36个月接受评估。结果采用改良的康威量表进行分类。

结果

在最近的随访中,22名患者中有19名结果优异。有2个结果一般,1个结果较差。较差的结果出现在一例翻修病例中。另外两例翻修的尺侧副韧带重建结果优异。该技术用于2例滑车结节撕脱病例时,结果优异。4例患者出现术后并发症:2例发生尺神经炎,2例需要二次手术松解粘连。这4例患者中有3例最终结果优异。

结论

临床上,初步结果与其他已发表的肘关节尺侧副韧带重建技术相比具有优势。这些早期数据支持在翻修病例和滑车结节骨量不足的病例中使用DANE TJ技术。

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