[创伤后及慢性韧带不稳定时肘关节尺侧副韧带重建术]
[Ulnar collateral ligament reconstruction of the elbow in posttraumatic and chronic ligament instability].
作者信息
Beck M, Wichelhaus A, Mittlmeier T
机构信息
Klinik für Orthopädie und Unfallchirurgie, St. Bernwardkrankenhaus Hildesheim, Treibestrassse 9, 31134, Hildesheim, Deutschland.
Abteilung für Unfall‑, Hand- und Wiederherstellungschirurgie, Universitätsmedizin Rostock, Rostock, Deutschland.
出版信息
Oper Orthop Traumatol. 2018 Feb;30(1):64-70. doi: 10.1007/s00064-017-0523-7. Epub 2017 Nov 20.
OBJECTIVE
Restoration of ulnar elbow stability in cases of posttraumatic and chronic ulnar ligament instability.
INDICATIONS
Symptomatic therapy-resistant ulnar ligament instability of the elbow.
CONTRAINDICATIONS
Arthrofibrosis and high-grade elbow arthrosis.
SURGICAL TECHNIQUE
Anatomical reconstruction of the ulnar collateral ligament (UCL) with autologous tendon graft (tendons of the palmaris longus muscle and gracilis muscle) in implant-free docking technique.
POSTOPERATIVE MANAGEMENT
A cast for 1 week, then 5 weeks orthesis with limitation of complete extension and flexion; full weight bearing after 3 months.
RESULTS
After 2 years 90% of the patients are able to return at an equal level of activity. The overall complication rate is 10.4%. The most common complication is ulnar nerve neurapraxia in 7.8% of the patients.
目的
恢复创伤后及慢性尺侧副韧带不稳定病例的尺侧肘关节稳定性。
适应症
有症状的、治疗抵抗的肘关节尺侧副韧带不稳定。
禁忌症
关节纤维性变和重度肘关节骨关节炎。
手术技术
采用无植入物对接技术，用自体肌腱移植物（掌长肌和股薄肌肌腱）对尺侧副韧带进行解剖重建。
术后处理
用石膏固定1周，然后使用矫形器5周，限制完全伸展和屈曲；3个月后完全负重。
结果
2年后，90%的患者能够恢复到同等活动水平。总体并发症发生率为10.4%。最常见的并发症是7.8%的患者出现尺神经失用症。
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