Charalambous C P, Stanley J K
Department of Upper Limb Surgery, Wrightington Hospital, Hall Lane, Appley Bridge, Wigan WN6 9EP, UK.
J Bone Joint Surg Br. 2008 Mar;90(3):272-9. doi: 10.1302/0301-620X.90B3.19868.
Posterolateral rotatory instability is the most common type of symptomatic chronic instability of the elbow. In this condition the forearm complex rotates externally in relation to the humerus, causing posterior subluxation or dislocation of the radial head. The lateral ligament complex, radial head and coronoid process are important constraints to posterolateral rotatory instability, and their disruption is involved in the pathogenesis of this condition. The diagnosis relies on a high index of clinical suspicion, active and passive apprehension tests, and examination under anaesthesia. Surgical treatment has given consistently successful results. Open reconstruction of the lateral ligaments with a tendon graft has been the procedure of choice, with arthroscopic techniques emerging as a potential alternative.
后外侧旋转不稳定是肘关节有症状的慢性不稳定最常见的类型。在这种情况下，前臂复合体相对于肱骨向外旋转，导致桡骨头后脱位或半脱位。外侧韧带复合体、桡骨头和冠突是后外侧旋转不稳定的重要制约因素，它们的损伤参与了这种情况的发病机制。诊断依赖于高度的临床怀疑、主动和被动恐惧试验以及麻醉下检查。手术治疗一直取得成功的结果。用肌腱移植进行外侧韧带的开放重建一直是首选的手术方法，关节镜技术正在成为一种潜在的替代方法。
