Regel G, Seekamp A, Blauth M, Zuleger A, Tscherne H
Unfallchirurgische Klinik, Medizinische Hochschule Hannover.
Unfallchirurg. 1998 Mar;101(3):193-200. doi: 10.1007/s001130050253.
Non-unions in the proximity of the elbow are very rare and in most cases caused by mistakes in initial treatment. Reconstruction after pseudarthrosis of the elbow continues to pose a challenge for any surgeon. The aim of our study was to analyze the initial mistakes and to underline the most important aspects of reconstructive surgery. In a retrospective study over a defined period of 10 years (1/1985 to 12/1994) we were able to treat altogether 27 non-unions in the proximity of the elbow. These patients were transferred to our hospital at an average of 44 weeks after initial therapy elsewhere. The main symptoms were in 17 cases pain and in all other patients functional deficit. Reconstructive surgery was performed an average 54 weeks after the primary injury. In 24 out of 27 cases a re-osteosynthesis, in 12 an arthrolysis, in 7 a neurolysis and in 2 cases an arthroplasty was needed. The patient could return to work an average 18 weeks after the operation and 53 weeks after injury. The initial complaints were reduced in 24 of 27 cases, with a significant improvement in the ROM and functional outcome according to the Mayo Elbow Performance Index.
肘部附近的骨不连非常罕见，在大多数情况下是由初始治疗失误导致的。对于任何外科医生来说，肘部假关节后的重建仍然是一项挑战。我们研究的目的是分析初始失误，并强调重建手术的最重要方面。在一项为期10年（1985年1月至1994年12月）的回顾性研究中，我们总共治疗了27例肘部附近的骨不连。这些患者在其他地方接受初始治疗后平均44周被转诊至我院。主要症状在17例中为疼痛，在所有其他患者中为功能缺陷。重建手术在初次受伤后平均54周进行。27例中有24例需要再次骨固定，12例需要关节松解，7例需要神经松解，2例需要关节成形术。患者术后平均18周、受伤后平均53周能够恢复工作。27例中有24例初始症状减轻，根据梅奥肘关节功能指数，ROM和功能结果有显著改善。
