Ahmad Christopher S, Vitale Mark A
Department of Orthopaedic Surgery, Columbia University, New York, NY, USA.
Instr Course Lect. 2011;60:171-80.
Elbow arthroscopy has become an accepted treatment for numerous elbow conditions, including loose bodies, lateral epicondylitis, contractures, painful osteophytes, synovitis, osteochondritis dissecans, synovial plica, and osteoarthritis. It is absolutely necessary that the treating surgeon have complete knowledge of elbow anatomy. Three options exist for patient positioning: supine, prone, and lateral decubitus. Standard arthroscopic probes, grasping forceps, punches, and motorized shavers and burrs are used in the procedure. Retractors are essential for visualizing, exposing, and protecting nerves. Specially designed capsular biters can be used to develop a plane between the capsule and the surrounding soft tissues to facilitate capsulotomy and capsulectomy. Among elbow arthroscopists, the sequence of portal placement varies; however, there is little variation in the exact location of portal placement because of neurovascular constraints. Loose body removal and extensor carpi radialis brevis release for lateral epicondylitis are common procedures suitable for the beginning arthroscopist. For beginning and advanced procedures, the surgeon's skill and competence must be at a level consistent with the procedure to avoid complications.
肘关节镜检查已成为治疗多种肘部疾病的公认方法，这些疾病包括游离体、外侧上髁炎、挛缩、疼痛性骨赘、滑膜炎、剥脱性骨软骨炎、滑膜皱襞和骨关节炎。治疗外科医生必须全面了解肘部解剖结构。患者体位有三种选择：仰卧位、俯卧位和侧卧位。手术中使用标准的关节镜探头、抓钳、咬骨钳以及电动刨削器和磨钻。牵开器对于观察、暴露和保护神经至关重要。可使用专门设计的关节囊咬骨钳在关节囊与周围软组织之间形成一个平面，以利于关节囊切开术和关节囊切除术。在肘关节镜手术医生中，入口放置的顺序各不相同；然而，由于神经血管的限制，入口放置的确切位置差异不大。游离体取出术和针对外侧上髁炎的桡侧腕短伸肌松解术是适合初入门关节镜手术医生的常见手术。对于初阶和进阶手术，外科医生的技能和能力必须与手术相匹配，以避免并发症。
