Louer Craig R, Calfee Ryan P
Department of Orthopaedic Surgery, Washington University, Saint Louis, MO.
Tech Hand Up Extrem Surg. 2015 Jun;19(2):84-7. doi: 10.1097/BTH.0000000000000084.
In Monteggia fracture dislocations of the elbow, the lateral collateral ligament complex is disrupted as the radial head dislocates from the capitellum. A persistently incompetent lateral ulnar collateral ligament (LUCL) predisposes to posterolateral rotary instability of the elbow, thus restoration of the LUCL is essential for recovery. Although LUCL disruptions following elbow dislocations typically occur at the lateral humeral origin, we have identified a series of Monteggia injuries where the LUCL is avulsed from its ulnar insertion along with a fracture fragment containing the crista supinatoris. Failure to recognize and appropriately treat the crista supinatoris fracture in this injury may result in LUCL incompetence and risk symptomatic instability. The following technique describes the recognition and surgical treatment of Monteggia injuries, specifically recognizing the crista supinatoris fracture. Using this technique, patients reliably experience good functional outcomes with normal elbow stability.
在孟氏骨折脱位中，随着桡骨头从肱骨小头脱位，外侧副韧带复合体遭到破坏。持续存在功能不全的尺侧副韧带（LUCL）会导致肘关节后外侧旋转不稳定，因此恢复LUCL对康复至关重要。尽管肘关节脱位后LUCL损伤通常发生在肱骨外侧起点处，但我们发现了一系列孟氏损伤病例，其中LUCL从其尺侧附着点连同包含旋后肌嵴的骨折块一起被撕脱。未能识别并妥善处理该损伤中的旋后肌嵴骨折可能会导致LUCL功能不全，并引发症状性不稳定。以下技术描述了孟氏损伤的识别与手术治疗，尤其强调对旋后肌嵴骨折的识别。采用该技术，患者能可靠地获得良好的功能预后，且肘关节稳定性正常。
