Viswanath Aparna, Thomas Jill L, Watts Adam C
Upper limb unit, Wrightington Hospital, Wigan, UK.
Shoulder Elbow. 2022 Apr;14(2):194-199. doi: 10.1177/1758573220987850. Epub 2021 Jan 18.
The coronoid is one of the elbow's primary static stabilisers, and the importance of reconstruction following fracture with instability has been established. In the developing elbow, instability can lead to greater sigmoid notch dysplasia that can make reconstruction challenging. A novel technique to improve osseous stability with an opening wedge 'stamp osteotomy' reconstruction of the coronoid is described combined with a lateral ligament reconstruction, in two patients with recurrent posteromedial rotatory instability. The technique improves congruity and coverage of the greater sigmoid notch with the trochlea whilst maintaining articular cartilage. Extra-articular iliac crest bone graft is used to maintain the position with buttress plate support. The surgical technique is described and the clinical and radiographic outcome reported in two patients. Level of evidence: IV.
冠突是肘部主要的静态稳定结构之一，骨折后伴不稳定时进行重建的重要性已得到证实。在发育中的肘部，不稳定可导致更大的乙状切迹发育异常，这会使重建具有挑战性。本文描述了一种新颖的技术，即采用开放楔形“邮票截骨术”重建冠突，同时进行外侧韧带重建，用于治疗两名复发性后内侧旋转不稳定患者，以提高骨稳定性。该技术在保持关节软骨的同时，改善了滑车与更大乙状切迹的一致性和覆盖度。采用关节外髂嵴骨移植，并使用支撑钢板维持其位置。本文描述了手术技术，并报告了两名患者的临床和影像学结果。证据等级：IV级。
