Hamoodi Zaid, Singh Jagwant, Elvey Michael H, Watts Adam C
Wrightington Upper Limb Unit, Wigan, UK.
Shoulder Elbow. 2023 Feb;15(1):94-103. doi: 10.1177/17585732221113534. Epub 2022 Jul 21.
This study aims to review the functional outcomes of patients managed by the application of the Wrightington elbow fracture-dislocation classification system and its corresponding management algorithms.
This is a retrospective consecutive case series of patients over the age of 16 with an elbow fracture-dislocation managed according to the Wrightington classification. The primary outcome was the Mayo Elbow Performance Score (MEPS) at the last follow-up. Range of movement (ROM) and complications were collected as a secondary outcome.
Sixty patients qualified for inclusion (32 female, 28 male) with a mean age of 48 years (19-84). Fifty-eight (97%) patients completed a minimum of three months follow-up. Mean follow-up was six months (3-18). The median MEPS at the final follow-up was 100 (interquartile range [IQR] 85-100) and median ROM of 123° (IQR 101-130) degrees. Four patients underwent secondary surgery and had improved outcomes with the average MEPS score improving from 65 to 94 following the second surgery.
The results of this study show that good outcomes can be achieved for complex elbow fracture-dislocations through pattern recognition and management with an anatomically based reconstruction algorithm as described by the Wrightington classification system.
本研究旨在回顾应用赖廷顿肘关节骨折脱位分类系统及其相应治疗算法治疗的患者的功能结局。
这是一项回顾性连续病例系列研究，纳入了16岁以上根据赖廷顿分类法治疗的肘关节骨折脱位患者。主要结局是最后一次随访时的梅奥肘关节功能评分（MEPS）。收集活动范围（ROM）和并发症作为次要结局。
60例患者符合纳入标准（32例女性，28例男性），平均年龄48岁（19 - 84岁）。58例（97%）患者完成了至少3个月的随访。平均随访时间为6个月（3 - 18个月）。最后一次随访时的MEPS中位数为100（四分位间距[IQR] 85 - 100），ROM中位数为123°（IQR 101 - 130）。4例患者接受了二次手术，术后结局改善，第二次手术后平均MEPS评分从65提高到94。
本研究结果表明，通过如赖廷顿分类系统所描述的基于解剖结构的重建算法进行模式识别和治疗，复杂的肘关节骨折脱位可取得良好的结局。
