Lee Yeon Soo, Alcid Jess G, McGarry Michelle H, ElAttrache Neal S, Lee Thay Q
Orthopaedic Biomechanics Laboratory, VA Long Beach Healthcare System, Long Beach, California 90822, USA.
Orthopedics. 2008 Jul;31(7):648.
This study aimed to assess the effect of posteromedial olecranon resection on the stability of the elbow joint, forearm kinematics, and strain in the anterior bundle of the medial ulnar collateral ligament. Seven elbows were tested after resecting all soft tissues except the capsuloligamentous structures. Varus-valgus angulation, forearm rotation, and the length of the anterior bundle of the medial ulnar collateral ligament were measured at 3 posteromedial olecranon resection stages of 0, 4, and 8 mm, and at elbow flexion angles of 30 degrees, 60 degrees, and 90 degrees. Posteromedial olecranon resection significantly increased varus and valgus laxities at 60 degrees and 90 degrees of elbow flexion but had a larger effect on varus motion than valgus movement. With more posteromedial olecranon resection, the valgus angulation and varus-valgus laxity proportionally increased. In most cases, parallel resections of the posteromedial olecranon significantly decreased the functional varus-valgus stiffness. There was no significant effect on strain in the anterior bundle of the medial ulnar collateral ligament due to olecranon resection. When treating an overhead athlete with posteromedial olecranon impingement, the resection should be limited to osteophytic overgrowth. Throwers may be susceptible to ulnar collateral ligament injury following posteromedial olecranon resection due to increased elbow laxity.
本研究旨在评估尺骨鹰嘴后内侧切除术对肘关节稳定性、前臂运动学以及尺侧副韧带前束应变的影响。在切除除关节囊韧带结构外的所有软组织后,对7个肘关节进行了测试。在尺骨鹰嘴后内侧切除0、4和8mm的3个阶段,以及肘关节屈曲30度、60度和90度时,测量了内翻-外翻成角、前臂旋转以及尺侧副韧带前束的长度。尺骨鹰嘴后内侧切除术在肘关节屈曲60度和90度时显著增加了内翻和外翻松弛度,但对内翻运动的影响大于外翻运动。随着尺骨鹰嘴后内侧切除量的增加,外翻成角和内翻-外翻松弛度成比例增加。在大多数情况下,尺骨鹰嘴后内侧的平行切除显著降低了功能性内翻-外翻刚度。尺骨鹰嘴切除对尺侧副韧带前束的应变没有显著影响。在治疗患有尺骨鹰嘴后内侧撞击的过头运动员时,切除应仅限于骨赘过度生长。由于肘关节松弛度增加,投掷运动员在尺骨鹰嘴后内侧切除后可能易患尺侧副韧带损伤。