Tarallo L, Mugnai R, Rocchi M, Rovesta C, Catani F
Department of Orthopaedics and Traumatology, University of Modena and Reggio Emilia, Via del Pozzo 71, 41124, Modena, Italy.
Musculoskelet Surg. 2016 Dec;100(Suppl 1):105-110. doi: 10.1007/s12306-016-0420-5. Epub 2016 Nov 30.
Distal humeral malunions are uncommon injuries, often associated with limited elbow motion, pain, instability, weakness, and sometimes ulnar neuritis. The complex anatomy of the elbow joint makes this condition one of the most complex elbow injuries to treat.
Four patients were treated by the same surgeon between 2011 and 2013 using a double-locking precontoured plating system for malunited intra-articular or extra-articular fractures of the distal end of the humerus.
At a mean 3 years of follow-up, a significant improvement in the elbow motion and functional outcome, evaluated with the Mayo Elbow Performance Index and the Disability of the Arm, Shoulder, and Hand, were observed. Articular reduction obtained after the surgery was maintained in all patients without evidence of avascular necrosis. No other complications (i.e., infection, nervous iatrogenic lesions) were reported.
Corrective osteotomy using double-locking precontoured plating system preceded by preoperative planning using a CT scan allowed an improvement in the functional outcome and elbow motion, without complications.
肱骨远端畸形愈合是一种少见的损伤,常伴有肘关节活动受限、疼痛、不稳定、无力,有时还会出现尺神经炎。肘关节复杂的解剖结构使这种情况成为最难治疗的肘关节损伤之一。
2011年至2013年间,同一位外科医生使用双锁定预塑形钢板系统治疗了4例肱骨远端关节内或关节外骨折畸形愈合的患者。
平均随访3年时,通过梅奥肘关节功能指数和上肢、肩部和手部功能障碍评估发现,肘关节活动度和功能结果有显著改善。所有患者术后均维持了关节复位,无缺血性坏死迹象。未报告其他并发症(如感染、医源性神经损伤)。
术前使用CT扫描进行规划,然后采用双锁定预塑形钢板系统进行截骨矫正,可改善功能结果和肘关节活动度,且无并发症。