Davis R F, Weiland A J, Hungerford D S, Moore J R, Volenec-Dowling S
Clin Orthop Relat Res. 1982 Nov-Dec(171):156-60.
Thirty capitellocondylar unhinged implant arthroplasties were performed on 27 patients during the period from October 1976 through June 1981. The average patient age was 59.4 years, with a preoperative diagnosis of rheumatoid arthritis in 28 elbows and osteoarthritis in two elbows. Follow-up periods averaged 39.9 months (range, 10-62 months). The indication for elbow arthroplasty were intractable pain, joint instability, failed synovectomy, or bilateral limitation of motion. Ranged of motion evaluations showed moderate increases in flexion, pronation and supination after operation, although there was no significant improvement in extension. Ewald functional evaluation scores improved significantly from the mean of eight points prior to operation to the postoperative mean of 85 points. The significant complications occurring were deep wound infections, necessitating removal of the prosthesis (6.6%), and subluxation (13.2%), which responded to conservative treatment by long-arm casting. One patient required reconstruction of the medial collateral ligament for subluxation. Ulnar nerve paresthesia developed in 10% of the patients. One patient required neurolysis and transposition of the nerve for relief of symptoms. The posterolateral approach was adopted to reduce the incidence of ulnar nerve complications.
1976年10月至1981年6月期间，对27例患者实施了30例肱骨小头髁非铰链式植入物关节成形术。患者平均年龄为59.4岁，术前诊断为类风湿关节炎的有28例肘部，骨关节炎的有2例肘部。随访期平均为39.9个月（范围10 - 62个月）。肘关节成形术的指征为顽固性疼痛、关节不稳定、滑膜切除术失败或双侧活动受限。活动度评估显示术后屈曲、旋前和旋后有适度增加，尽管伸展没有显著改善。埃瓦尔德功能评估评分从术前平均8分显著提高到术后平均85分。发生的严重并发症有深部伤口感染，需要取出假体（6.6%），以及半脱位（13.2%），通过长臂石膏固定进行保守治疗有效。1例患者因半脱位需要重建内侧副韧带。10%的患者出现尺神经感觉异常。1例患者需要进行神经松解和神经移位以缓解症状。采用后外侧入路以降低尺神经并发症的发生率。
