Donohue Kenneth W, Mehlhoff Thomas L
From the Department of Orthopaedic Surgery, Baylor College of Medicine, Houston, TX (Dr. Donohue) and the Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX (Dr. Mehlhoff).
J Am Acad Orthop Surg. 2016 Jul;24(7):413-23. doi: 10.5435/JAAOS-D-14-00460.
Chronic elbow dislocation is defined as a dislocation that has remained unreduced for >2 weeks. The soft-tissue and skeletal changes that develop during this time usually prevent successful closed reduction. These changes include the development of extensive intra-articular fibrotic tissue, as well as contracture of the triceps, collateral ligaments, and elbow capsule. Ulnar nerve involvement and associated fractures may also be present. Because treatment of chronic elbow dislocation is challenging, a stepwise approach is used in the evaluation and management of this condition. No large series of data are available to guide treatment. Most patients are treated on the basis of the surgeon's anecdotal experience. Treatment typically involves open reduction, often with the use of hinged external fixators. The role of triceps lengthening or primary collateral ligament reconstruction remains a topic of debate.
慢性肘关节脱位的定义为脱位持续未复位超过2周。在此期间发生的软组织和骨骼变化通常会阻碍成功的闭合复位。这些变化包括广泛的关节内纤维化组织的形成，以及肱三头肌、侧副韧带和肘关节囊的挛缩。尺神经受累及相关骨折也可能存在。由于慢性肘关节脱位的治疗具有挑战性，因此在评估和处理这种情况时采用逐步方法。目前尚无大量数据可用于指导治疗。大多数患者的治疗基于外科医生的经验。治疗通常包括切开复位，常使用铰链式外固定架。肱三头肌延长或一期侧副韧带重建的作用仍是一个有争议的话题。
