Katsuyama Yusei, Nakamura Shinichiro, Sasaki Kentaro, Umeda Koichi, Takahashi Kenji
Department of Orthopedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kamigyo-ku, Kyoto 602-8566, Japan.
Department of Orthopaedics, Fukuchiyama City Hospital, 231 Atsunaka-cho, Fukuchiyama, Kyoto 620-8505, Japan.
J Surg Case Rep. 2024 Aug 28;2024(8):rjae542. doi: 10.1093/jscr/rjae542. eCollection 2024 Aug.
A 65-year-old woman presented with right elbow pain after a fall. Imaging showed an avulsion fracture of the olecranon. The patient subsequently underwent surgery using the suture bridge technique with anchors. However, loosening was observed intraoperatively. Therefore, a McLaughlin cerclage with an artificial ligament was added, resulting in a rigid fixation. Bone union was achieved at 4 months postoperatively. At 18 months postoperatively, no limitation was observed in the range of motion of the elbow joint; the disabilities of the arm, shoulder and hand score was 0. McLaughlin cerclage with an artificial ligament provided additional fixation, demonstrating greater strength compared with suture anchors and minimizing the risk of cut-through in the osteoporotic bone. This approach offers a promising alternative for such cases by combining firm fixation with a reduced risk of complications, particularly in older patients with osteoporosis.
一名65岁女性在跌倒后出现右肘疼痛。影像学检查显示鹰嘴撕脱骨折。该患者随后接受了使用锚钉的缝线桥技术手术。然而,术中观察到松动。因此,添加了带人工韧带的麦克劳林环扎术,实现了牢固固定。术后4个月实现骨愈合。术后18个月,肘关节活动范围无受限;手臂、肩部和手部功能障碍评分0分。带人工韧带的麦克劳林环扎术提供了额外的固定,与缝线锚钉相比显示出更大的强度,并将骨质疏松骨中锚钉穿出的风险降至最低。这种方法通过将牢固固定与降低并发症风险相结合,为这类病例提供了一种有前景的替代方案,特别是对于患有骨质疏松症的老年患者。