Erhart Stefanie, Lutz Martin, Deml Christian, Sitte Ingrid, Angermann Peter
Department for Trauma Surgery, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
Department for Trauma Surgery, Landeskrankenhaus Hall, Milser Strasse 10, 6060, Hall in Tirol, Austria.
Arch Orthop Trauma Surg. 2017 Feb;137(2):225-232. doi: 10.1007/s00402-016-2623-5. Epub 2017 Jan 12.
The coronoid is a crucial element for elbow stability. In case of posttraumatic instability or reduced range of motion, a complex reconstruction might be necessary.
We present the case of a polytraumatized patient with complex upper extremity injury and initial poor outcome. Subluxation after initial surgery was treated by sublime tubercle reconstruction with a corticocancellous iliac crest graft. Due to massive ossification, the elbow remained stiff and the paraplegic patient was unable to use a manually propelled wheelchair. After arthrolysis, the unstable elbow was treated with an osteocartilaginous graft from the navicular of the foot as well as ulnar and radial collateral ligamentoplasties. At the time of follow-up, the patient had a stable joint and was able to independently perform activities of daily living.
An autologous navicular graft seems to be an excellent option for our paraplegic patient as the shape matches the sublime tubercle of the ulna.
冠突是维持肘关节稳定性的关键结构。若出现创伤后不稳定或活动范围减小的情况，可能需要进行复杂的重建手术。
我们报告了一例多发伤患者，其上肢复合伤，初期预后不佳。初次手术后出现半脱位，采用带皮质骨松质的髂嵴移植重建小结节进行治疗。由于大量骨化，肘关节仍僵硬，该截瘫患者无法使用手动轮椅。行关节松解术后，采用取自足舟骨的骨软骨移植以及尺侧和桡侧副韧带成形术治疗不稳定的肘关节。随访时，患者关节稳定，能够独立进行日常生活活动。
自体舟骨移植对我们的截瘫患者似乎是一个极佳的选择，因为其形状与尺骨小结节相匹配。
