Micic Ivan, Kim Shin-Yoon, Park Il-Hyung, Kim Poong-Taek, Jeon In-Ho
Clinic for Orthopaedic Surgery and Traumatology, Clinical Center Nis, Nis, Serbia.
Int Orthop. 2009 Aug;33(4):1141-7. doi: 10.1007/s00264-008-0624-x. Epub 2008 Aug 2.
The purpose of this study was to describe soft tissue injury patterns and report the clinical results of primary ligament repair with use of protected early mobilisation in unstable elbow dislocations with pure capsulo-ligamentous injuries. Twenty-four patients who presented with traumatic unstable elbow dislocation without associated intra-articular fracture were reviewed. Anatomical repair was performed using metal anchor screws and the bone tunnel method. Ligament avulsion was noted in 55% for the medial collateral ligament, 80% for the lateral collateral ligament, 60% for the flexor tendon and 80% for the extensor tendon. The overall mean Mayo Elbow Performance Score was 93.2. Brachial artery injuries occurred in two elbows. Heterotopic calcification was noted in 14 patients and there was one severe traumatic arthrosis. This study showed a high incidence of reattachable avulsion injuries to ligaments, tendon/muscle and capsule in unstable elbow dislocations. Primary ligament repair coupled with early rehabilitation provided satisfactory outcomes at two to four years postoperatively.
本研究的目的是描述软组织损伤模式，并报告在单纯关节囊韧带损伤的不稳定肘关节脱位中，采用保护性早期活动进行一期韧带修复的临床结果。回顾了24例无相关关节内骨折的创伤性不稳定肘关节脱位患者。采用金属锚钉和骨隧道法进行解剖修复。内侧副韧带撕脱率为55%，外侧副韧带为80%，屈肌腱为60%，伸肌腱为80%。梅奥肘关节功能评分总体平均分为93.2。2例肘关节出现肱动脉损伤。14例患者出现异位钙化，1例出现严重创伤性关节炎。本研究表明，不稳定肘关节脱位中韧带、肌腱/肌肉和关节囊可重新附着的撕脱伤发生率较高。一期韧带修复联合早期康复在术后两到四年提供了满意的结果。
