Department of Surgery, University of Western Ontario, London, ON N6A 4L6, Canada.
J Bone Joint Surg Am. 2010 Apr;92(4):949-57. doi: 10.2106/JBJS.H.01873.
The amount of the olecranon that can be removed without substantially affecting the kinematics and stability of the elbow is controversial. The purpose of this study was to determine the effect of serial resections of the olecranon on elbow kinematics and stability.
Eight fresh, previously frozen cadaver arms were mounted in an in vitro motion simulator, and kinematic data were obtained with use of an electromagnetic tracking system for active and passive motion. Flexion was studied in the varus, valgus, horizontal, and dependent positions. Custom-written three-dimensional computer navigation software was utilized to guide serial resection of the olecranon in 12.5% increments from 0% to 100%. A traditional triceps advancement repair was performed following each resection. Flexion angle, amount of olecranon resection, and active and passive motion measurements were compared.
Serial resection of the olecranon resulted in a significant increase in varus-valgus angulation with the arm in the varus (p < 0.04) and valgus (p = 0.01) orientations. Ulnohumeral rotation significantly increased in the varus (p < 0.001) and valgus (p < 0.007) orientations. Angular (p = 0.02) and rotational (p < 0.001) kinematics were greater with passive compared with active motion. There was no difference in elbow kinematics following olecranon resection with the arm positioned in the horizontal and dependent positions.
Valgus-varus angulation and ulnohumeral rotation progressively increase with sequential excision of up to 75% of the olecranon. Elbow stability is progressively lost with sequential excision, with gross instability noted at resection of > or = 87.5% of the olecranon.
切除尺骨鹰嘴的量，如果不显著影响肘部的运动学和稳定性，是有争议的。本研究的目的是确定尺骨鹰嘴连续切除对肘部运动学和稳定性的影响。
将 8 个新鲜、先前冷冻的尸体手臂安装在体外运动模拟器中，使用电磁跟踪系统获得主动和被动运动的运动学数据。在内翻、外翻、水平和依赖位置研究了屈曲。使用定制的三维计算机导航软件，从 0%到 100%以 12.5%的增量引导尺骨鹰嘴的连续切除。在每次切除后进行传统的三头肌推进修复。比较了屈曲角度、尺骨鹰嘴切除量以及主动和被动运动测量值。
尺骨鹰嘴连续切除导致内翻-外翻角度在手臂内翻（p < 0.04）和外翻（p = 0.01）位置时显著增加。尺骨肱旋转在内翻（p < 0.001）和外翻（p < 0.007）位置显著增加。与主动运动相比，被动运动的角度（p = 0.02）和旋转（p < 0.001）运动学更大。在手臂处于水平和依赖位置时，尺骨鹰嘴切除后肘部运动学没有差异。
随着尺骨鹰嘴连续切除，外翻-内翻角度和尺骨肱旋转逐渐增加，最大切除量可达 75%。随着连续切除，肘关节稳定性逐渐丧失，切除>或= 87.5%的尺骨鹰嘴时，出现明显不稳定。
