复杂肘关节损伤的机制化分型与治疗思考

Mechanism typing and treatment reflection of complex elbow injury

肘关节复杂损伤一直是临床处理的难点,其相关研究众多,然而预后一直不佳。传统的肘关节复杂骨折以关键附属结构分型为主,如桡骨小头的Mason分型、尺骨冠状突的Regan-Morrey或O'Driscoll分型;对于肘关节静力性稳定系统的病因学分型一般采用Heim的四柱理论解释,其众多分型较难理解和归纳。本文整合了常见的6型肘关节复杂损伤,以机制化诊断进行归类,以期指导手术治疗;并对于手术中的难点、桡骨小头和尺骨冠状突的重建、外侧韧带复合体损伤的修复与否提出了一定的临床建议。

Complex elbow injury has been a difficult problem in clinical treatment,and the prognoses are not always satisfied despite of many related studies. Traditional complex elbow fracture classifications are mainly based on a key accessory structure to guide the surgical treatment,such as Mason type for radial head fracture and Regan-Morrey type for the corocoid process fracture. Therefore,elbow joint static stabilizing system of etiologic typing is commonly used by Heim s theory. This study integrates six common kinds of elbow joint injuries and classifies based on the mechanism of diagnosis,so as to offer a more reasonable reference for difficulties in surgery treatment for this injury,especially radial head and coronoid reconstruction or repair of lateral collateral ligament complex injury.