Department of Orthopedic Surgery, Soonchunhyang University, College of Medicine, Bucheon, South Korea.
J Shoulder Elbow Surg. 2013 Nov;22(11):1469-73. doi: 10.1016/j.jse.2013.06.018. Epub 2013 Sep 3.
We evaluated the clinical outcome and findings of ligamentous repair for acute posterolateral rotatory instability (PLRI) of the elbow.
Nineteen patients underwent lateral collateral ligament repair for acute PLRI. Ten male and nine female patients were observed for a mean of 9 months; their mean age was 46 years (14-70 years). The mean time from injury to operation was 8.1 days (1-18 days). The lateral pivot shift and varus stress test results were positive for all cases. We repaired the lateral ulnar collateral ligament with Ethibond in 6 cases and Bio-FASTak in 15 cases. We evaluated the range of motion, pain, and stability by the satisfaction of the patient, the Mayo Elbow Performance Score, and the Nestor grading.
The lateral pivot shift test result was negative in all patients at the final follow-up. The mean elbow extension was 13°; flexion, 120°; supination, 74°; and pronation, 78°. Mild valgus laxity was noted in two patients who had mild pain on activity. The mean Mayo Elbow Performance Score was 86.9 points (65-100 points), with 13 excellent cases, 5 good cases, and 1 fair case. According to the Nestor grading, the results were rated excellent in 14 patients and good in 5. All patients were satisfied with their outcome in the subjective assessment. The complications were 1 case of knot irritation and 5 cases of ectopic ossification.
We obtained satisfactory outcomes with lateral collateral ligament repair for acute PLRI of the elbow.
我们评估了急性肘后外侧旋转不稳定(PLRI)的韧带修复的临床结果和发现。
19 例患者接受了外侧副韧带修复术治疗急性 PLRI。10 例为男性,9 例为女性,平均随访 9 个月;平均年龄为 46 岁(14-70 岁)。从受伤到手术的平均时间为 8.1 天(1-18 天)。所有病例的外侧枢轴转移和内翻应力试验结果均为阳性。我们用 Ethibond 在 6 例和 Bio-FASTak 在 15 例患者中修复了外侧尺侧副韧带。我们通过患者满意度、Mayo 肘功能评分和 Nestor 分级来评估活动范围、疼痛和稳定性。
所有患者在最终随访时的外侧枢轴转移试验结果均为阴性。平均肘伸为 13°;屈曲为 120°;旋前为 74°;旋后为 78°。两名患者活动时轻度疼痛,有轻度外翻松弛。平均 Mayo 肘功能评分为 86.9 分(65-100 分),优 13 例,良 5 例,可 1 例。根据 Nestor 分级,14 例患者结果为优,5 例为良。所有患者在主观评估中对其结果均满意。并发症为 1 例结刺激,5 例异位骨化。
我们通过外侧副韧带修复术治疗急性肘后外侧旋转不稳定获得了满意的结果。