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肘关节后外侧脱位:尺侧副韧带全关节镜下重建术

Posterolateral Elbow Dislocation: An All-Arthroscopic Reconstruction of the Lateral Ulnar Collateral Ligament.

作者信息

Martínez Martínez Francisco, Martínez García Celia, García López Antonio, Vallés Andreu Moises, Calvo-Guirado Jose Luis, Simón Pérez Clarisa

机构信息

Department of Orthopedic Surgery, Hospital Universitario Virgen de la Arrixaca, Ctra Madrid-Cartagena, Murcia, Spain.

Department of Orthopedic Surgery, Hospital General Universitario Dr. Balmis, Alicante, Spain.

出版信息

Arthrosc Tech. 2024 Jun 29;13(11):103096. doi: 10.1016/j.eats.2024.103096. eCollection 2024 Nov.

Abstract

The elbow is one of the most commonly dislocated joints. Although simple dislocations of the elbow usually resolve with conservative management, certain patients can experience residual chronic instability. Posterolateral rotational instability accounts for approximately 80% of elbow chronic instability cases. We propose an all-arthroscopic reconstruction of the posterior, or ulnar, fascicle of the lateral ligament complex using an autograft or allograft, performed with a 5-mm-thick and 8-cm-long graft. The graft is first inserted distally into the supinator crest with an Arthrex 4.75-mm SwiveLock implant and, finally, at its origin in the epicondyle, also with a screw of the same characteristics. Arthroscopic techniques create fewer complications. This procedure allows the surgeon to address intra-articular elbow joint pathology with less chance of wound complications and the ability to use bone anchors if desired.

摘要

肘关节是最常发生脱位的关节之一。虽然肘关节单纯脱位通常通过保守治疗即可恢复,但某些患者可能会出现残留的慢性不稳定。后外侧旋转不稳定约占肘关节慢性不稳定病例的80%。我们建议使用自体移植物或同种异体移植物,通过全关节镜对外侧韧带复合体的后束(即尺侧束)进行重建,移植物厚度为5毫米,长度为8厘米。首先使用Arthrex 4.75毫米SwiveLock植入物将移植物向远侧插入旋后肌嵴,最后在其位于上髁的起点处,也使用相同规格的螺钉固定。关节镜技术产生的并发症较少。该手术使外科医生能够处理肘关节内的病理情况,伤口并发症的几率较小,并且如有需要还能够使用骨锚。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/401e/11662868/a069fc81c36c/gr1.jpg

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