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关节镜下肱骨小头和滑车骨折复位及内固定:病例系列

Arthroscopic reduction and internal fixation of capitellar and trochlear fractures: A case series.

作者信息

Zhang Yiyang, Chang Nicholas, Athwal George S, King Graham Jw

机构信息

Roth|McFarlane Hand and Upper Limb Center, St Joseph's Health Care, Division of Orthopaedic Surgery, University of Western Ontario, London, ON, Canada.

出版信息

Shoulder Elbow. 2023 Feb;15(1):75-81. doi: 10.1177/17585732211037617. Epub 2021 Dec 7.

Abstract

BACKGROUND

In a simple isolated capitellar/trochlear fracture without extensive posterior comminution, arthroscopic reduction and internal fixation (ARIF) can provide an alternative option to open reduction internal fixation. The purpose of this retrospective case series was to report on the technique and outcomes of arthroscopic reduction and internal fixation of capitellar/trochlear fractures.

METHODS

All patients that underwent ARIF at a single upper extremity referral centre in the last twenty years were reviewed. Patient demographics, preoperative, intraoperative, and postoperative records were obtained through chart review and telephone followup.

RESULTS

Ten cases of ARIF were identified over a twenty year period performed by two surgeons. The average age of patients was 37 years (17-63 years), with nine females and one male. With an average followup of eight years, nine of ten patients had a mean range of motion from 0 to 142 degrees. Their average MEPI and PREE score were 93 ± 7 and 8 ± 14, respectively. Four patients had focal cartilage collapse with three that required a reoperation. There were no infections, nonunions, or arthroscopy related complications.

CONCLUSION

ARIF offers an alternative to ORIF for capitellar/trochlear fractures producing good results while providing better visualization of the fracture reduction and minimizing soft tissue dissection.

摘要

背景

在单纯的孤立性肱骨小头/滑车骨折且无广泛的后方粉碎的情况下,关节镜下复位内固定(ARIF)可为切开复位内固定提供一种替代选择。本回顾性病例系列的目的是报告肱骨小头/滑车骨折关节镜下复位内固定的技术及结果。

方法

回顾了过去二十年间在一个上肢转诊中心接受ARIF治疗的所有患者。通过病历审查和电话随访获取患者的人口统计学资料、术前、术中和术后记录。

结果

在二十年期间,两位外科医生共完成了10例ARIF手术。患者的平均年龄为37岁(17 - 63岁),其中女性9例,男性1例。平均随访8年,10例患者中有9例的平均活动范围为0至142度。他们的平均MEPI和PREE评分分别为93±7和8±14。4例患者出现局限性软骨塌陷,其中3例需要再次手术。无感染、骨不连或与关节镜相关的并发症。

结论

对于肱骨小头/滑车骨折,ARIF为切开复位内固定提供了一种替代方法,能产生良好的效果,同时能更好地观察骨折复位情况并将软组织剥离减至最少。

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Capitellar and Trochlear Fractures.肱骨小头和滑车骨折。
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