Neumann R, Donner K
Fortschr Med. 1982 Sep 23;100(36):1678-81.
Compared to the frequency of manifestation of rheumatoid arthritis in the elbow joint the quota of surgical intervention in this area is low. In most cases pain and disability are only moderate, especially if the reduced range of motion is compensated by maintained function of the equilateral shoulder and wrist joint. Surgical treatment is indicated if instability increases, the independency of the patients in daily life is endangered and inflammation increases acutely. A persistent compression of n. ulnaris has to be operated as soon as possible. Often the preferred early synovectomy is impossible because of priority of other joints. By late synovectomy, however, good results can be expected regarding stability, function and extent of pain. In our cases the joint was opened from radial and ulnar in combination with ventralization of the ulnaris nerve. The replacement of the head of radius by a silastic-spacer seems to reduce the secondary irritation in the radial part of the joint and to increase stability. The own method for resection-arthroplasty in modification of the method of Hass with interposition of the middle part of triceps tendon is described and discussed. Because of imminent loosening prostheses are implanted very rarely.
与类风湿性关节炎在肘关节的表现频率相比，该部位的手术干预比例较低。在大多数情况下，疼痛和功能障碍仅为中度，尤其是如果等边的肩关节和腕关节功能得以维持，从而代偿了活动范围的减小。如果不稳定情况加剧、患者的日常生活独立性受到威胁且炎症急性加重，则需进行手术治疗。尺神经持续受压必须尽快手术。由于其他关节更为优先，早期滑膜切除术往往无法实施。然而，通过晚期滑膜切除术，在稳定性、功能和疼痛程度方面有望取得良好效果。在我们的病例中，从桡侧和尺侧打开关节，并将尺神经腹侧移位。用硅橡胶间隔物置换桡骨头似乎可以减少关节桡侧部分的继发性刺激并增加稳定性。描述并讨论了我们自己改良哈斯（Hass）法进行切除关节成形术的方法，即在肱三头肌腱中部进行间置。由于假体松动风险较大，很少植入假体。
