Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, TX, USA.
Department of Orthopaedic Surgery and Rehabilitation, William Beaumont Army Medical Center, El Paso, TX, USA.
J Shoulder Elbow Surg. 2018 Jan;27(1):112-117. doi: 10.1016/j.jse.2017.08.015. Epub 2017 Oct 31.
The purpose of this investigation was to characterize the functional and surgical outcomes following lateral ulnar collateral ligament (LUCL) reconstruction for posterolateral rotatory instability in an athletic population.
All US military service members who underwent LUCL reconstruction between 2008 and 2013 were identified. A retrospective chart review was performed, and the prospective Mayo Elbow Performance Score and QuickDASH (short version of Disabilities of the Arm, Shoulder and Hand questionnaire) score were obtained. The primary outcomes were return to preinjury activity and resolution of symptoms.
We identified 23 patients with a mean age of 31.6 ± 7.2 years (range, 19-46 years), and 87% were men. A history of instability and/or dislocation was reported by 11 patients (48%), and 8 patients (35%) had undergone prior elbow surgery. At final follow-up of 4.6 ± 1.8 years (range, 2.2-7.6 years), all patients demonstrated significant decreases in pain (average pain score, 4 vs 1.34) with resolution of instability and achieved a functional arc of motion. After surgical reconstruction, 83% were able to return to prior activity, whereas 4 patients (17%) underwent medical separation, including 3 with elbow disability precluding continued service (13%). Overall 83% of patients reported good to excellent outcomes by the Mayo Elbow Performance Score, and 96% of patients reported no significant disability by the QuickDASH disability evaluation. Postoperatively, 4 patients (17%) experienced complications, with 3 (13%) requiring reoperation.
Although the diagnosis and surgical management of isolated LUCL injury are relatively infrequent, LUCL reconstruction for posterolateral rotatory instability offers a reliable return to preinjury level of function among active individuals with intense upper extremity demands. However, although function reliably improves, the rate of perioperative complications is greater than 15%.
本研究的目的是描述在运动人群中，外侧尺侧副韧带（LUCL）重建治疗后外侧旋转不稳定的功能和手术结果。
确定了 2008 年至 2013 年间接受 LUCL 重建的所有美国军事人员。进行了回顾性图表审查，并获得了前瞻性 Mayo 肘功能评分和 QuickDASH（手臂、肩部和手残疾问卷的简短版本）评分。主要结果是恢复到受伤前的活动水平和症状缓解。
我们共识别了 23 名平均年龄为 31.6±7.2 岁（范围 19-46 岁）的患者，其中 87%为男性。11 名患者（48%）有不稳定和/或脱位史，8 名患者（35%）曾接受过肘部手术。最终随访 4.6±1.8 年（范围 2.2-7.6 年），所有患者的疼痛均显著减轻（平均疼痛评分从 4 分降至 1.34 分），且不稳定得到解决，并实现了功能活动度。手术后，83%的患者能够恢复到之前的活动水平，而 4 名患者（17%）因医疗原因退役，其中 3 名因肘部残疾而无法继续服役（13%）。总体而言，83%的患者通过 Mayo 肘功能评分报告了良好至优秀的结果，96%的患者通过 QuickDASH 残疾评估报告了无明显残疾。术后 4 名患者（17%）发生并发症，其中 3 名（13%）需要再次手术。
尽管孤立性 LUCL 损伤的诊断和手术治疗相对少见，但 LUCL 重建治疗后外侧旋转不稳定在高强度上肢需求的活跃人群中可提供可靠的恢复到受伤前的功能水平。然而，尽管功能确实得到了改善，但围手术期并发症的发生率超过 15%。
