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[肘关节后外侧旋转不稳定——一例报告及外侧副韧带的解剖学研究]

[Posterolateral rotatory instability of the elbow--a case report and anatomical study of the lateral collateral ligament].

作者信息

Horii E, Nakamura R, Watanabe K, Tamura Y, Tsunoda K, Kawano M

机构信息

Department of Orthopaedic Surgery, Branch Hospital, Nagoya University School of Medicine, Aichi, Japan.

出版信息

Nihon Seikeigeka Gakkai Zasshi. 1993 Jan;67(1):34-9.

PMID:8454924
Abstract

A 20-year-old woman was referred to our clinic complaining of recurrent subluxation of her right elbow. A posterolateral rotatory instability test revealed that she had insufficiency of the lateral collateral ligament. She was surgically treated; the ligament was reconstructed by using the palmaris longus tendon. A year after operation, she had no pain in her elbow, and regained full range of elbow motion. The function of the lateral collateral ligament is often overlooked. We, therefore, dissected 24 elbow joints and studied anatomically in order to confirm the origin and insertion of the lateral collateral ligament. The ligament originates from the lateral epicondyle, and runs distally in fan shape. It further inserts partly to the annular ligament and partly to the supinator crest. After complete sectioning of the ligament, the forearm was fixed in supination, then flexed with valgus moment. This maneuver elicited subluxation of the radio-humeral joint, which was similar to what we observed in the clinical case. From these observations, we have concluded that the ligament is important for stability of elbow joint as well as the medial collateral ligament.

摘要

一名20岁女性因右肘反复半脱位被转诊至我院。后外侧旋转不稳定试验显示她的外侧副韧带功能不全。她接受了手术治疗,使用掌长肌腱重建了韧带。术后一年,她的肘部无疼痛,且恢复了肘部的全范围活动。外侧副韧带的功能常被忽视。因此,我们解剖了24个肘关节并进行解剖学研究,以确认外侧副韧带的起止点。该韧带起自外侧髁,呈扇形向远端走行。它进一步部分附着于环状韧带,部分附着于旋后肌嵴。在完全切断韧带后,将前臂固定于旋后位,然后在有外翻力矩的情况下屈曲。此操作引发了桡肱关节半脱位,这与我们在临床病例中观察到的情况相似。基于这些观察结果,我们得出结论,该韧带对于肘关节的稳定性以及内侧副韧带同样重要。

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