人工全肘关节置换在严重肘关节创伤中的初步应用

Treatment of severe traumatic elbows by total elbow arthroplasty

目的 分析人工全肘关节置换治疗严重肘关节创伤的疗效。方法 对5例严重肘关节创伤患者采用人工全肘关节置换术治疗。本组术前均有较严重的肘关节功能障碍。结果 本组5例获14～56个月的随访，平均随访25个月。1例术后28个月出现假体无菌性松动。其余4例至随访截止时无人工关节松动、感染等并发症发生。采用Mayo Clinic肘关节翻修术后功能评分，术前评分平均44分（30～55分），术后平均评分82分（65～90分）。结论 严重肘关节创伤后骨不连、畸形愈合、创伤性关节炎以及肘关节活动障碍等的治疗非常困难，人工全肘关节置换为其提供了一种有效的治疗方法，初步的结果令人满意。

Objective To analyze the treatment effects of total elbow arthroplasty on severe traumatic conditions of elbow. Methods Five cases of severe traumatic elbow were treated by total elbow artbroplasty. The elbow function was poor before total elbow arthroplasty in all the cases. Results All the cases were followed up for 14-25 months. Aseptic loosening of the elbow prosthesis was found in 1 case 2.4 years postoperatively. No prosthesis loosening,infection and other complications were found in the other 4 patients at the end of the follow-up. Preoperative and postoperative clinical function were assessed with Mayo post-revision elbow performance score, the score at the follow-up was improved from 44（30-55 points） to 82（65-90 points）. Conclusion Severe traumatic elbow with fracture nonunions,malunions,posttraumatic arthritis,and elbow motion disturbance is difficult to treat. Total elbow arthroplasty should be considered as an effective and safe treatment method in these problems.