定轴外固定架在肘关节内翻-后内侧旋转不稳定损伤当中的应用

Application of External Fixation of Fixed Axial Fixation in Unstable Internal Injury of Elbow

目的评估定轴外固定架在手术治疗肘关节内翻-后内侧旋转不稳定损伤中的临床价值。方法回顾性分析37例接受切开复位钢板内固定联合定轴外固定架固定治疗的肘关节内翻-后内侧旋转不稳定损伤患者资料,其中男28例,女9例,平均年龄31.5岁,采用Mayo肘关节功能评分系统评定术后肘关节功能。结果 37例患者平均随访15.34个月。术后肘关节平均屈曲(135.14±4.61)°,平均伸直(4.56±8.37)°,平均屈伸范围(133.12±9.56)°,平均旋前(87.68±6.21)°,平均旋后(85.79±2.97)°。Mayo评分63~96分,平均(82±13)分,其中优19例,良15例,可3例。1例患者出现较明显异位骨化,仅伸直受限约30°;另1例患者出现尺神经麻痹,保守治疗4周后恢复。所有患者均未出现肘关节不稳定、关节疼痛、肘内翻等并发症。结论联合使用定轴外固定架在手术治疗肘关节内翻-后内侧旋转不稳定损伤中可以获得良好的临床效果,是一种较为理想的手术方法选择。

Objective To assess the clinical evaluation of the fixed axis external fixator used in the surgical treatment for elbow varus posteromedial rotational instability.Methods A total of37patients material who accepted the surgery of open reduction plate fixation and fixed axis external fixator for elbow varus posteromedial rotational instability were analyzed respectively,include28male and9female,with an average age of31.5years.Postoperative elbow function was assessed use the Mayo elbow function scoring system.Result The mean follow-up was15.34months for the37cases.The mean postoperative elbow flexion angle was(135.14±4.61)°,extension was(4.56±8.37)°,with a mean flexion-extension rang of(133.12±9.56)°,the mean postoperative elbow pronation and supination angle was(87.68±6.21)°and(85.79±2.97)°,respectively.The mean Mayo scores was(82±13)ranged from63to96,and19cases were excellent,15good and3fair.While1case complicated with significant heterotopic ossification,only have a residual limited extension of30°,ulnar nerve palsy was found only in another1case,however,the symptom was completely remitted after a4weeks conservation treatment.Complications of elbow instability,joint pain,elbow varus were not found in all cases.Conclusion The combination of fixed axis external fixator in surgical treatment for elbow varus posteromedial rotational instability could achieve a favorable clinical outcome,it could be a ideal surgical method choice for such injury.