Josefsson P O, Johnell O, Wendeberg B
Clin Orthop Relat Res. 1987 Aug(221):221-5.
The opinions concerning presence of instability and ligamentous injuries following dislocation of the elbow differ. Thirty-one patients with an elbow dislocation without concomitant fracture were examined under anesthesia for stability at an average time of two days after the injury. All elbows were unstable to valgus stress in the extended position compared with the healthy side. Eight elbows were unstable to varus stress. Nine elbows were easily redislocated in semiflexed position under anesthesia. Surgical exposure and ligament suture were performed medially in all cases and laterally in 18 cases. All the ligaments were completely ruptured or avulsed in the epicondyle attachment. In most cases the ligamentous ruptures were combined with rupture or avulsion of the muscular origins at the epicondyles. The degree of muscular damage was correlated with the tendency to redislocate under anesthesia.
关于肘关节脱位后是否存在不稳定及韧带损伤的观点存在差异。31例无合并骨折的肘关节脱位患者在受伤后平均两天接受麻醉下的稳定性检查。与健侧相比,所有肘关节在伸直位时对外翻应力均不稳定。8例肘关节对内翻应力不稳定。9例肘关节在麻醉下于半屈曲位容易再脱位。所有病例均在内侧进行手术显露和韧带缝合,18例在外侧进行。所有韧带均在髁上附着处完全断裂或撕脱。在大多数情况下,韧带断裂合并髁上肌肉起点的断裂或撕脱。肌肉损伤程度与麻醉下再脱位的倾向相关。