Département d'orthopédie et traumatologie, CHU de Dijon, 21000 Dijon, France.
Hôpitaux universitaires de Genève, avenue Gabrielle-Perret-Gentil 4, 1205 Genève, Switzerland.
Orthop Traumatol Surg Res. 2021 Apr;107(2):102829. doi: 10.1016/j.otsr.2021.102829. Epub 2021 Jan 29.
Isolated traumatic radial head dislocation is exceedingly rare in adults, usually diagnosed on an emergency basis, and reduced by external manoeuvres. If the diagnosis is not made immediately, external reduction is no longer feasible. Various options have been described for treating these chronic forms, including therapeutic abstention, radial head resection and annular ligamentoplasty combined, if appropriate, with osteotomy of the ulna. In patients with incapacitating symptoms, proposing a surgical option makes sense. Here, we describe the technique developed by PM Grammont, which combines ligamentoplasty and an oblique flat osteotomy of the ulna. We used this technique in a 31-year-old male with isolated anterior dislocation of the radial head of 3 months' duration. One year after surgery, he had fully recovered range of motion in all planes. He returned to work 5 months after surgery. The promising clinical and radiological outcomes in our patient support the use of this technique in adults with chronic isolated radial head dislocation. LEVEL OF EVIDENCE: IV.
成人孤立性创伤性桡骨头脱位极为罕见,通常在急诊时诊断,并通过外部手法复位。如果不能立即作出诊断,外部复位将不再可行。对于这些慢性病例,已经描述了各种治疗方法,包括治疗性保守治疗、桡骨头切除术以及环状韧带成形术,如果合适的话,还可以结合尺骨截骨术。对于有功能障碍症状的患者,提出手术治疗方案是有意义的。在这里,我们描述了由 PM Grammont 开发的技术,该技术结合了韧带成形术和尺骨斜形平截骨术。我们在一名 31 岁男性中使用了这种技术,该患者患有 3 个月的孤立性桡骨头前脱位。手术后 1 年,他在所有平面上的活动范围完全恢复。手术后 5 个月他恢复工作。我们患者的有前景的临床和影像学结果支持在成人慢性孤立性桡骨头脱位中使用这种技术。证据水平:IV。