Degreef Ilse
a Department of Orthopaedic Surgery , University Hospitals Leuven , Leuven , Belgium.
Acta Chir Belg. 2016 Apr;116(2):73-80. doi: 10.1080/00015458.2016.1147246.
Background The elbow joint is a complex compound articulation, with a linking role within the upper limb kinematics. Its hinge function allows for proper placement of our working instrument (the hand) in the space surrounding us, directed by the shoulder joint. Both reliable mobility and stability are essential elements to allow for consistent bridging of the distance we aim to achieve in common daily activities. Sufficient flexion and extension are required to ensure both the patients' independence and the dignity. Next to the hinge, a radio-ulnar rotation with precise co-operation of forearm and wrist spin enhances the linking function with accurate precision instrument manipulation. Arthritis of the elbow joint or cubarthritis, whether primary or secondary, may not be as highly prevalent as hip or knee arthritis, but its impact on daily live certainly cannot be underestimated. Methods Current treatment options for failing cubarthritis are reviewed. Results Surgical techniques to reconstruct or replace the elbow joint are currently increasingly efficient with mounting long-term outcome reports. Debridement techniques including open or arthroscopic Outerbridge-Kashiwaghi procedure often delays joint replacement. Implants for joint arthroplasty focus on the ulna-humeral joint mostly with semi-constrained linked techniques, but there is a trend towards total joint replacement including the radiocapitellar joint. Conclusion In this independent review article, elbow joint failure due to cubarthritis and an overview of its current state-of-the-art orthopaedic treatment algorithm is presented, with its indications, advantages, risks and outcome.
背景 肘关节是一个复杂的复合关节，在上肢运动学中起连接作用。其铰链功能使我们的工作工具（手）在肩关节的引导下，能在我们周围的空间中正确定位。可靠的活动度和稳定性都是在日常活动中实现我们预期距离的连贯衔接所必需的要素。需要足够的屈伸来确保患者的独立性和尊严。除了铰链功能外，桡尺旋转以及前臂和腕部旋转的精确协同作用，可通过精确的器械操作增强连接功能。肘关节关节炎或肘部关节炎，无论是原发性还是继发性，其发病率可能不如髋关节炎或膝关节炎高，但其对日常生活的影响肯定不容低估。方法 对目前针对失败的肘部关节炎的治疗选择进行综述。结果 随着长期疗效报告的增多，目前用于重建或置换肘关节的手术技术越来越有效。包括开放或关节镜下的Outerbridge-Kashiwaghi手术在内的清创技术往往会延迟关节置换。关节置换植入物主要集中在尺肱关节，大多采用半约束连接技术，但有向包括桡骨头关节在内的全关节置换发展的趋势。结论 在这篇独立综述文章中，介绍了因肘部关节炎导致的肘关节功能障碍及其当前最先进的骨科治疗算法概述，包括其适应症、优点、风险和疗效。
