Li Tao, Li Xing-Long, Hu Shi-Xiang, Sun Wei, Wu Jing
Department of Emergency and Trauma Surgery, Jining No.1 People's Hospital, Jining Department of Orthopedics, Yankuang Group Genaral Hospital, Zoucheng Department of Surgery, Xizou Health Center of Qufu, Qufu Department of Surgery, Taiping Town Health Center of Zoucheng, Zoucheng, P.R. China.
Medicine (Baltimore). 2018 Apr;97(15):e0398. doi: 10.1097/MD.0000000000010398.
The terrible triad of the elbow (TTE) is a difficult injury, and the usual TTE consists of posterior dislocation of the elbow, radial head fracture, and coronoid fracture. The target of this retrospective study is to explore the effect, postoperative complications, and prognostic factors in patients with TTE undergoing arthroscopic surgery with three different operative approaches.
Patients with TTE underwent arthroscopic surgery were treated using lateral, anterior medial, or combined lateral and anterior medial approaches, respectively. In order to analyze the postoperative complications and the effect of arthroscopic surgery for patients with TTE, the function of elbow joint before and after the surgery was evaluated and the flexion-extension of elbow joint and rotation of elbow joint and forearm were measured.
The evaluation results obtained from patients underwent 3 different operative approaches revealed that after surgery, patients receiving arthroscopic surgery using combined lateral and anterior medial approach had superior flexion-extension of elbow joint, rotation of elbow joint and forearm, higher Mayo Elbow Performance Score (MEPS) and more cases of Broberg-Morrey grade 0, and lower complication rate, compared with those using lateral or anterior medial approach. A key finding in the study demonstrated that fracture type, operative approach, and postoperative complications were factors related with the effect of arthroscopic surgery for patients with TTE.
Collectively, the key findings obtained from the present study supported the notion that the effect of arthroscopic surgery in combined lateral and anterior medial approach is much better than in lateral approach or anterior medial approach, and is related with fracture type, operative approach, and postoperative complications.
肘关节恐怖三联征（TTE）是一种复杂的损伤，典型的TTE包括肘关节后脱位、桡骨头骨折和冠状突骨折。本回顾性研究的目的是探讨采用三种不同手术入路的关节镜手术治疗TTE患者的疗效、术后并发症及预后因素。
对接受关节镜手术的TTE患者分别采用外侧、前内侧或外侧与前内侧联合入路进行治疗。为分析关节镜手术治疗TTE患者的术后并发症及疗效，评估手术前后肘关节功能，测量肘关节屈伸、肘关节及前臂旋转情况。
对接受3种不同手术入路的患者进行评估，结果显示，与采用外侧或前内侧入路的患者相比，采用外侧与前内侧联合入路进行关节镜手术的患者术后肘关节屈伸、肘关节及前臂旋转功能更佳，Mayo肘关节功能评分（MEPS）更高，Broberg-Morrey 0级病例更多，并发症发生率更低。该研究的一项关键发现表明，骨折类型、手术入路和术后并发症是影响TTE患者关节镜手术疗效的因素。
总体而言，本研究的关键发现支持以下观点：外侧与前内侧联合入路的关节镜手术疗效远优于外侧入路或前内侧入路，且与骨折类型、手术入路和术后并发症有关。
