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肘部恐怖三联征:手术治疗的功能结果

TERRIBLE TRIAD OF THE ELBOW: FUNCTIONAL RESULTS OF SURGICAL TREATMENT.

作者信息

Ikemoto Roberto Yukio, Murachovsky Joel, Bueno Rogério Serpone, Nascimento Luis Gustavo Prata, Carmargo Adriano Bordini, Corrêa Vitor Elias

机构信息

. Shoulder and Elbow Surgery Group, Faculdade Medicina do ABC, Santo André, SP, Brazil.

. Department of Orthopedics, Hospital Ipiranga (UGA II), São Paulo, SP, Brazil.

出版信息

Acta Ortop Bras. 2017 Nov-Dec;25(6):283-286. doi: 10.1590/1413-785220172506168821.

Abstract

OBJECTIVE

To evaluate the functional and radiographic results of patients who underwent surgical treatment for terrible triad-type elbow injuries (TTE).

METHODS

We retrospectively evaluated 20 patients, including one case with bilateral injuries (total of 21 elbows) that were surgically treated from January 2004 to July 2014. We evaluated the functional results of treatment by measuring the restored range of motion (ROM) of the elbow, using the DASH (Disabilities of the Arm, Shoulder and Hand) and MEPS (Mayo Elbow Performance Score) scores. Complications and the development of osteoarthritis and heterotopic ossification (HO) were also evaluated.

RESULTS

Eight elbows (38%) required additional surgical treatment; HO was observed in eight elbows (38%) and severe osteoarthritis (Broberg-Morrey type IV) was seen in only one case (4%). Nevertheless, we obtained good functional results, 14.27 on the DASH and 84 on the MEPS. The average ROM for flexion-extension was 101° (20-140°) and for pronation-supination was 112.85° (0-180°).

CONCLUSION

When TTE injuries are treated systematically, even despite variations in these injuries, functional ROM and scores ranging from good to excellent can be obtained.

摘要

目的

评估接受手术治疗的恐怖三联征型肘关节损伤(TTE)患者的功能和影像学结果。

方法

我们回顾性评估了20例患者,包括1例双侧损伤患者(共21个肘关节),这些患者于2004年1月至2014年7月接受了手术治疗。我们通过测量肘关节恢复的活动范围(ROM)、使用上肢、肩部和手部功能障碍(DASH)评分及梅奥肘关节功能评分(MEPS)来评估治疗的功能结果。还评估了并发症以及骨关节炎和异位骨化(HO)的发生情况。

结果

8个肘关节(38%)需要再次手术治疗;8个肘关节(38%)观察到异位骨化,仅1例(4%)出现严重骨关节炎(Broberg-Morrey IV型)。然而,我们获得了良好的功能结果,DASH评分为14.27,MEPS评分为84。屈伸平均ROM为101°(20 - 140°),旋前-旋后平均ROM为112.85°(0 - 180°)。

结论

当对恐怖三联征损伤进行系统治疗时,即使这些损伤存在差异,仍可获得良好至优秀的功能ROM和评分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2558/5782865/0b76affcf99d/1413-7852-aob-25-06-00283-gf1.jpg

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