Breen T, Gelberman R H, Leffert R, Botte M
Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston 02114.
J Hand Surg Am. 1988 Nov;13(6):900-7. doi: 10.1016/0363-5023(88)90268-7.
Four elbow osteoarticular allografts were done for four patients as salvage procedures for unreconstructable elbow fracture malunions. With a mean follow-up of 60 months (range, 12 to 72 months) all elbows were stable, free of pain, and had mean motion of 130 degrees active flexion and 27 degrees of flexion deformity, 67 degrees pronation and 62 degrees supination (preoperative mean: 104 degrees flexion, 42 degrees flexion contracture, 20 degrees pronation, and 34 degrees supination). Complications occurred in two elbows. One had a deep infection necessitating graft removal and subsequent regrafting. The second had an olecranon osteotomy nonunion. Elbow allografting is recommended as a salvage procedure for massive posttraumatic articular defects, bone loss, or malunion when neither arthrodesis nor conventional arthroplasty is indicated.
对4例患者进行了4次肘关节骨关节异体移植，作为不可重建的肘关节骨折畸形愈合的挽救手术。平均随访60个月（范围12至72个月），所有肘关节均稳定、无疼痛，平均主动屈曲活动度为130度，屈曲畸形为27度，旋前67度，旋后62度（术前平均：屈曲104度，屈曲挛缩42度，旋前20度，旋后34度）。2例肘关节出现并发症。1例发生深部感染，需要取出移植物并随后再次移植。第2例鹰嘴截骨不愈合。当既不适合关节融合术也不适合传统关节成形术时，推荐肘关节异体移植作为严重创伤后关节缺损、骨丢失或畸形愈合的挽救手术。
