Philadelphia Hand Center, P.C., 834 Chestnut Street, G114, Philadelphia, PA 19107. E-mail address:
Orthopaedic Hand and Upper Extremity Service, Massachusetts General Hospital, Yawkey 2100, 55 Fruit Street, Boston, MA 02114.
J Bone Joint Surg Am. 2014 Aug 6;96(15):1308-1316. doi: 10.2106/JBJS.M.00817.
➤ There are patterns of traumatic elbow instability that help a surgeon to anticipate which structures are injured.➤ Patients treated for persistent subluxation or dislocation of the elbow more than two weeks after injury regain less motion and experience more adverse events.➤ The primary goal of treatment is stable reduction of the ulnohumeral joint and functional elbow motion.➤ Motion and pain are affected by contracture and scarring of the soft tissues, malalignment of the joint, fracture malunion, damage to the articular surface, and ulnar neuropathy.➤ Biomechanical and clinical studies support treatment with radial head arthroplasty and/or coronoid reconstruction for patients who have osseous insufficiency.
➤ 创伤性肘不稳定有一定的模式,有助于外科医生预测哪些结构受伤。➤ 受伤后超过 2 周接受治疗的持续性半脱位或脱位患者,其活动度恢复较差,且出现更多不良事件。➤ 治疗的主要目标是稳定地复位尺肱关节并恢复肘部功能活动。➤ 活动度和疼痛受软组织挛缩和瘢痕、关节对线不良、骨折畸形愈合、关节面损伤和尺神经病变的影响。➤ 生物力学和临床研究支持对存在骨质不足的患者行桡骨头置换和(或)冠状突重建治疗。