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一种基于伸肌总起点完整性的新型肘关节后外侧旋转不稳定（PLRI）手术治疗管理算法

A Novel Surgical Treatment Management Algorithm for Elbow Posterolateral Rotatory Instability (PLRI) Based on the Common Extensor Origin Integrity.

作者信息

Koukos Christos, Kotsapas Michail, Sidiropoulos Konstantinos, Traverso Aurélien, Bilsel Kerem, Montoya Fredy, Arrigoni Paolo

机构信息

Medical Center Wuppertal, 42329 Wuppertal, Germany.

Sports Trauma and Pain Ιnstitute, 54655 Thessaloniki, Greece.

出版信息

J Clin Med. 2024 Apr 20;13(8):2411. doi: 10.3390/jcm13082411.

DOI:10.3390/jcm13082411
PMID:38673685
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11051432/
Abstract

: Here, we introduce a comprehensive treatment algorithm for posterolateral rotatory instability (PLRI) of the elbow, a condition affecting elbow mobility. We outline a diagnostic approach and a novel surgical management plan through the arthroscopic surgeon's point of view. : The central focus of this management approach is the integrity of common extensor origin (CEO). High clinical suspicion must be evident to diagnose PLRI. Special clinical and imaging tests can confirm PLRI but sometimes the final confirmation is established during the arthroscopic treatment. The most appropriate treatment is determined by the degree of CEO integrity. : The treatment strategy varies with the CEO's condition: intact or minor tears require arthroscopic lateral collateral ligament imbrication, while extensive tears may need plication reinforced with imbrication or, in cases of retraction, a triceps tendon autograft reconstruction of the lateral ulnar collateral ligament alongside CEO repair. These approaches aim to manage residual instability and are complemented using a tailored rehabilitation protocol to optimize functional outcomes. : PLRI is a unique clinical condition and should be treated likewise. This algorithm offers valuable insights for diagnosing and treating PLRI, enhancing therapeutic decision-making.

摘要

在此，我们介绍一种针对肘部后外侧旋转不稳定（PLRI）的综合治疗算法，这种情况会影响肘部活动度。我们从关节镜外科医生的角度概述了一种诊断方法和一种新颖的手术管理计划。：这种管理方法的核心重点是伸肌总起点（CEO）的完整性。诊断PLRI必须有高度的临床怀疑。特殊的临床和影像学检查可以确诊PLRI，但有时最终确诊是在关节镜治疗过程中确定的。最合适的治疗方法取决于CEO的完整程度。：治疗策略因CEO的情况而异：完整或轻度撕裂需要关节镜下外侧副韧带叠瓦成形术，而广泛撕裂可能需要叠瓦成形术加强的折叠术，或者在回缩的情况下，在修复CEO的同时进行尺侧副韧带的肱三头肌腱自体移植重建。这些方法旨在处理残余不稳定，并辅以量身定制的康复方案以优化功能结果。：PLRI是一种独特的临床情况，应同样进行治疗。该算法为诊断和治疗PLRI提供了有价值的见解，增强了治疗决策。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/712b/11051432/52589b59c248/jcm-13-02411-g012.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/712b/11051432/62efec0fde51/jcm-13-02411-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/712b/11051432/8c91737faa93/jcm-13-02411-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/712b/11051432/d51bb4b131b9/jcm-13-02411-g009.jpg
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