Kang Yuxiang, Wang Shujun, Ren Zhipeng, Zhang Xinan, Li Jianan, Liu Haonan, Wei Wanfu
Department of Orthopaedics Trauma, Tianjin Hospital, Tianjin, 300211 China.
First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, 300380 China.
Indian J Orthop. 2024 May 1;58(6):778-784. doi: 10.1007/s43465-024-01128-0. eCollection 2024 Jun.
The aim of this study to investigate the safety and effectiveness of performing the hanging arm test during surgical treatment for elbow varus posteromedial rotatory instability (VPMRI) to assess elbow stability and determine whether to repair the lateral ulnar collateral ligament (LUCL).
In a retrospective study from August 2014 to March 2019, 27 patients with VPMRI who had a negative result in the hanging arm test after fixation of coronoid fracture were selected. Intraoperative bleeding, operative time, elbow range of motion (ROM), and complications were recorded. Elbow function was evaluated with the Mayo elbow performance score (MEPS) and the disabilities of the arm, shoulder, and hand (DASH) score.
The operation time was 85.9 ± 11.06 min (range 65-110). The intraoperative blood loss was 70.7 ± 9.31 ml (range 60-100). At the last follow-up, the elbow joint averaged 73.8° ± 2.931° in pronation, 78.9° ± 2.941° in supination, 7.2° ± 3.207° in extension, and 123.3° ± 6.651° in flexion. The MEPS score was 90.7 ± 4.36 (range 74-95), and the DASH score was 9.8 ± 2.58 (range 6.67-13.3). One patient presented with symptoms of ulnar nerve entrapment 2 months after operation and was treated with ulnar nerve release. The symptom of numbness went away completely 1 week after operation. No complications such as wound infection, arthritis, or chronic instability of the elbow were found in the other patients.
Our findings suggest that not all VPMRI patients need the LUCL to be repaired, and the hanging arm test is a safe and reliable method to assess whether to repair the LUCL in the treatment of elbow VPMRI.
Level IV; Retrospective studies.
本研究旨在探讨在手术治疗肘内翻后内侧旋转不稳定（VPMRI）期间进行悬臂试验以评估肘关节稳定性并确定是否修复尺侧副韧带（LUCL）的安全性和有效性。
在一项2014年8月至2019年3月的回顾性研究中，选择了27例冠状突骨折固定后悬臂试验结果为阴性的VPMRI患者。记录术中出血、手术时间、肘关节活动范围（ROM）和并发症。采用Mayo肘关节功能评分（MEPS）和上肢、肩部和手部功能障碍（DASH）评分评估肘关节功能。
手术时间为85.9±11.06分钟（范围65 - 110分钟）。术中失血量为70.7±9.31毫升（范围60 - 100毫升）。在最后一次随访时，肘关节平均旋前73.8°±2.931°，旋后78.9°±2.941°，伸展7.2°±3.207°，屈曲123.3°±6.651°。MEPS评分为90.7±4.36（范围74 - 95），DASH评分为9.8±2.58（范围6.67 - 13.3）。1例患者术后2个月出现尺神经卡压症状，接受了尺神经松解术。术后1周麻木症状完全消失。其他患者未发现伤口感染、关节炎或肘关节慢性不稳定等并发症。
我们的研究结果表明，并非所有VPMRI患者都需要修复LUCL，悬臂试验是评估在治疗肘VPMRI时是否修复LUCL的一种安全可靠的方法。
IV级；回顾性研究。
