Department of Orthopaedic Surgery, Division of Hand and Upper-Extremity Surgery, Geisinger Commonwealth School of Medicine, Danville, PA, USA.
Department of Orthopaedic Surgery, Division of Hand & Wrist Surgery, NYU Langone Health, New York City, NY, USA.
J Hand Surg Am. 2024 Apr;49(4):362-371. doi: 10.1016/j.jhsa.2023.10.015. Epub 2023 Nov 23.
Persistent and recurrent postoperative elbow instability includes a spectrum of pathologies ranging from joint incongruity and subluxation to dislocation. Restoration of osseous anatomy, particularly the coronoid, is a priority in restoring elbow alignment and maintaining ulnohumeral joint stability. After managing bony deficiencies, soft-tissue and ligamentous structures are typically addressed. When required, both static and dynamic adjunctive stabilization procedures have been described, which aid in maintaining a concentric reduction. In these complex procedures, both complication avoidance and early recognition of postoperative complications assist in obtaining a good result. In this review, we discuss current treatment options for revision stabilization for patients with persistent and recurrent elbow subluxation or dislocation after primary stabilization.
持续性和复发性术后肘不稳定包括一系列病理变化,从关节不和谐和半脱位到脱位。恢复骨骼解剖结构,特别是冠状突,是恢复肘部对线和维持尺肱关节稳定性的首要任务。在处理骨缺损后,通常会处理软组织和韧带结构。在需要时,已经描述了静态和动态辅助稳定程序,这有助于维持同心复位。在这些复杂的程序中,避免并发症和早期识别术后并发症有助于获得良好的结果。在这篇综述中,我们讨论了原发性稳定后持续性和复发性肘半脱位或脱位患者的 Revision 稳定治疗的选择。