Department of Orthopaedic Surgery, Kaiser Permanente, San Diego, California, U.S.A..
Department of Orthopaedic Surgery, Center for Shoulder, Elbow, and Sports Medicine, Columbia University, New York, New York, U.S.A.
Arthroscopy. 2014 Jul;30(7):866-71. doi: 10.1016/j.arthro.2014.02.029. Epub 2014 Apr 14.
The purpose of this systematic review was to critically examine the outcomes of lateral ulnar collateral ligament reconstruction for posterolateral rotatory instability (PLRI) of the elbow.
A systematic review of the literature was performed. Two reviewers assessed and confirmed the methodologic and patient data from the included studies. Frequency-weighted means were calculated for outcomes that were present in multiple studies.
Eight studies fulfilled our criteria, and they included 130 patients. The mean age was 38.1 years, and the mean follow-up period was 44.5 months. Traumatic dislocation was the most common cause of PLRI. Of the studies that reported the Mayo Elbow Performance Score, 91% of patients had good or excellent results, with a frequency-weighted mean of 91. Improvement in elbow range of motion was noted (133° to 138° of flexion [P < .0001] and 6.6° to 3.9° of extension [P = .005]). A complication rate of 11% was noted, with recurrent instability noted to occur in 8% of patients.
PLRI of the elbow remains to be fully understood. Treatment strategies vary and should be performed based on surgeon experience and evidence available. Most patients will have good or excellent results after surgery; however, up to 11% of patients may have complications.
Level IV, systematic review of Level II through IV studies.
本系统评价的目的是批判性地评估外侧尺侧副韧带重建治疗肘后外侧旋转不稳定（PLRI）的结果。
对文献进行系统评价。两位审稿人评估并确认了纳入研究的方法学和患者数据。在多个研究中出现的结果计算了频率加权平均值。
八项研究符合我们的标准，共纳入 130 例患者。平均年龄为 38.1 岁，平均随访时间为 44.5 个月。创伤性脱位是 PLRI 最常见的原因。在报告 Mayo 肘部功能评分的研究中，91%的患者结果良好或优秀，频率加权平均值为 91。肘部活动范围得到改善（屈曲 133°至 138°，P<.0001；伸展 6.6°至 3.9°，P=0.005）。并发症发生率为 11%，8%的患者出现复发性不稳定。
肘后外侧旋转不稳定仍未被充分理解。治疗策略因外科医生经验和现有证据而异。大多数患者术后效果良好或优秀；然而，多达 11%的患者可能出现并发症。
IV 级，对 II 级至 IV 级研究的系统评价。
