Chen Neal C, Ring David
Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
Department of Orthopaedic Surgery, Hand and Upper Extremity Service, Massachusetts General Hospital, Boston, MA.
J Hand Surg Am. 2015 Nov;40(11):2297-303. doi: 10.1016/j.jhsa.2015.04.039. Epub 2015 Oct 1.
The treatment of terrible triad injuries of the elbow continues to evolve. Radial head fixation and arthroplasty, coronoid process fixation, and repair of the lateral collateral ligament continue to be the mainstays of treatment. In the elbow with persistent instability after repair of these elements, application of a static external fixation, hinged external fixation, ulnohumeral joint pinning, or an internal hinge may be needed. In patients who undergo treatment after the acute injury period, the coronoid may require reconstruction using radial head autograft, iliac crest autograft, olecranon autograft, or allograft.
肘部可怕三联征损伤的治疗方法不断发展。桡骨头固定与置换、冠突固定以及外侧副韧带修复仍是主要的治疗手段。在修复这些结构后仍存在持续不稳定的肘部,可能需要应用静态外固定、铰链式外固定、尺肱关节穿针或内置铰链。在急性损伤期过后接受治疗的患者中,冠突可能需要使用桡骨头自体移植、髂嵴自体移植、鹰嘴自体移植或同种异体移植进行重建。