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全肘关节、桡骨头和肱骨小头表面置换关节的放射学评价。

Radiologic review of total elbow, radial head, and capitellar resurfacing arthroplasty.

机构信息

Department of Radiology, Penn State Milton S Hershey Medical Center, 500 University Dr, Hershey, PA 17033, USA.

出版信息

Radiographics. 2012 Jan-Feb;32(1):129-49. doi: 10.1148/rg.321105733.

Abstract

The use of metal and pyrolytic carbon radial head implants, capitellar resurfacing, and total elbow arthroplasty has become common in contemporary orthopedic surgery practice. The goal of total elbow arthroplasty is to decrease pain and restore an acceptable range of motion to the elbow joint. Rheumatoid arthritis is the primary indication for total elbow arthroplasty; newer indications include primary or posttraumatic osteoarthritis, fracture nonunion, acute comminuted fractures of the elbow, and postoperative resection of a neoplasm. Unlike total elbow arthroplasty, radial head replacement is most commonly performed in patients with trauma. Radial head fractures account for 33% of all elbow fractures in adults and are often associated with ligament disruption and valgus instability at the elbow. The goals of capitellar resurfacing arthroplasty include prevention of secondary osteoarthritis of the radiocapitellar joint and erosion in patients with radial head arthroplasty. Effective postoperative radiologic assessment of these different types of elbow reconstructions requires an understanding of their basic component design, physiologic purpose, and normal postoperative appearance, as well as the appearance of complications. Radiologists may have little training and experience with these new orthopedic devices.

摘要

金属和热解碳头植入物、肱骨小头表面置换和全肘关节置换在当代骨科手术实践中已变得常见。全肘关节置换的目的是减轻疼痛并恢复肘关节可接受的活动范围。类风湿关节炎是全肘关节置换的主要适应证;较新的适应证包括原发性或创伤后骨关节炎、骨折不愈合、肘部急性粉碎性骨折以及术后切除肿瘤。与全肘关节置换不同,桡骨头置换最常用于创伤患者。桡骨头骨折占成人肘部骨折的 33%,常伴有韧带断裂和肘外翻不稳定。肱骨小头表面置换术的目的包括预防桡骨头置换患者的桡尺骨关节继发性骨关节炎和侵蚀。了解这些不同类型的肘部重建的基本组件设计、生理目的和正常术后表现以及并发症表现,对于有效进行术后放射学评估至关重要。放射科医生可能对这些新的矫形设备接受的培训和经验有限。

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