Rashid Abbas, Copas David, Granville-Chapman Jeremy, Watts Adam
Upper Limb Unit, University College London Hospital, London, UK.
Department of Trauma & Orthopaedics, Harrogate Hospital, Harrogate, UK.
Shoulder Elbow. 2019 Oct;11(5):378-383. doi: 10.1177/1758573217738138. Epub 2017 Nov 8.
If left untreated, varus posteromedial rotatory injuries of the elbow result in poor functional outcomes. Surgical treatment allows restoration of elbow kinematics, minimizing the chances of chronic varus instability and early onset osteoarthritis. However, large exposures are associated with extensive soft tissue stripping, a high risk of infection, nerve injury, poor visualization of the articular surface and longer recovery. Consequently, there has been renewed interest in the use of elbow arthroscopy to circumvent these problems. Arthroscopic treatment offers the potential advantage of a swift recovery, with instant rehabilitation, less stiffness and swelling than might be expected after open repair. We present the first combined arthroscopic-assisted anteromedial facet coronoid fracture fixation and lateral ulna collateral ligament repair in a varus posteromedial rotatory injury of the elbow.
如果不进行治疗,肘部内翻后内侧旋转损伤会导致功能预后不良。手术治疗可恢复肘部运动学,将慢性内翻不稳定和早期骨关节炎的发生几率降至最低。然而,大切口手术会导致广泛的软组织剥离、感染风险高、神经损伤、关节面可视化差以及恢复时间长。因此,人们重新对使用肘关节镜检查来规避这些问题产生了兴趣。关节镜治疗具有恢复迅速的潜在优势,与开放修复术后相比,康复即时,僵硬和肿胀程度更低。我们展示了首例在肘关节内翻后内侧旋转损伤中联合关节镜辅助下冠状突前内侧小面骨折固定和尺侧副韧带外侧修复的病例。