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肱三头肌外侧头是判定单纯后外侧肘关节脱位稳定性的预测指标:稳定与不稳定脱位的磁共振成像分析

Common Extensor Complex Is a Predictor to Determine the Stability in Simple Posterolateral Elbow Dislocation: Analysis of MR Images of Stable vs. Unstable Dislocation.

作者信息

Cho Chul-Hyun, Kim Beom-Soo, Yi Jaehyuck, Lee Hoseok, Kim Du-Han

机构信息

Department of Orthopedic Surgery, School of Medicine, Keimyung University, Daegu 42601, Korea.

Department of Radiology, School of Medicine, Keimyung University, Daegu 42601, Korea.

出版信息

J Clin Med. 2020 Sep 25;9(10):3094. doi: 10.3390/jcm9103094.

Abstract

Simple posterolateral elbow dislocations (SPLED) may be treated nonoperatively using closed reduction, followed by controlled mobilization. However, the extent of soft tissue injuries might affect the choice of treatment, rehabilitation approach, and prognosis. The purpose of this study is to compare the characteristics of soft tissue injuries between patients with unstable and stable SPLED using MRI findings. Thirty MRIs of elbows with SPLED (unstable group ( = 15); stable group ( = 15)) were randomly reviewed by two experienced musculoskeletal radiologists. Soft tissue injuries were characterized as an intact, partial tear or complete tear for the: medial collateral ligament (MCL) complex, common flexor complex, lateral collateral ligament (LCL) complex, common extensor complex, anterior capsule, and posterior capsule. Moderate to substantial interobserver reliability and substantial to perfect intraobserver reliability were observed for medial and lateral complexes in SPLED. The proportion of soft-tissue injuries of the common extensor complex were significantly different between the unstable (four partial tears and 11 complete tears) and stable groups (11 partial tears and four complete tears). In conclusion, based on MRI findings, the degree of common extensor complex injuries may be a predictor of stability and help inform treatment decisions for SPLED.

摘要

单纯后外侧肘关节脱位(SPLED)可采用闭合复位非手术治疗,随后进行控制性活动。然而,软组织损伤的程度可能会影响治疗选择、康复方法及预后。本研究旨在利用MRI结果比较不稳定型和稳定型SPLED患者软组织损伤的特征。两名经验丰富的肌肉骨骼放射科医生随机回顾了30例SPLED肘关节的MRI(不稳定组(n = 15);稳定组(n = 15))。软组织损伤被分为内侧副韧带(MCL)复合体、屈肌总腱、外侧副韧带(LCL)复合体、伸肌总腱、前关节囊和后关节囊的完整、部分撕裂或完全撕裂。在SPLED中,内侧和外侧复合体的观察者间信度为中度至高度,观察者内信度为高度至完美。不稳定组(4例部分撕裂和11例完全撕裂)和稳定组(11例部分撕裂和4例完全撕裂)伸肌总腱的软组织损伤比例有显著差异。总之,基于MRI结果,伸肌总腱损伤程度可能是稳定性的一个预测指标,并有助于为SPLED的治疗决策提供依据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d021/7601526/6b7d57b173ea/jcm-09-03094-g001.jpg

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