单一外侧入路和外侧入路联合前内侧入路治疗肘关节三联征的疗效分析

An Analysis of the Effects of the Terrible Elbow Triad Treated Through the Lateral Approach and the Combination of Lateral Approach and Anterior-Medial Approach

目的:探讨单一外侧入路和外侧入路联合前内侧治疗肘入路关节三联征的疗效对比。方法:采用回顾性队列研究分析我院2015年5月至2018年3月手术治疗的43例肘关节三联征患者,按照手术入路分为单一外侧入路(A组,24例)和外侧入路联合前内侧入路(B组,19例)。比较两组患者的手术时间、手术出血量、术后并发症、肘关节活动度及Mayo肘关节功能评分(MEPS)等。结果:两组患者的手术时间和出血量差异无统计学意义(P>0.05)。B组的尺神经损伤症状高于A组(P<0.05)。平均随访时间24.6月,终末随访时,A组肘关节屈曲、伸直、旋前、旋后活动度均较B组好,存在统计学上差异(P<0.05);A组运动功能评分高于B组,且存在统计学差异(P<0.05);A组MEPS总评分低于B组,但是不存在统计学差异(P>0.05)。结论:单一外侧入路及外侧入路联合前内侧入路治疗肘关节三联征均可获得较满意的疗效。单一外侧入可以较好减轻肘关节软组织的损伤,降低术后僵硬及尺神经损伤等风险,在术后肘关节活动度恢复有明显优势。

Objective:To investigate the clinical curative effects of terrible triad of elbow treated through lateral approach alone and through the combination of lateral approach and anterior-medial approach.Methods:Retrospective and cohort study was adopted in this research,which involved 43 patients from May 2015 to March 2018 in our department.Patients were randomly assigned to group A(n=24)and group B(n=19).Clinical curative effects were evaluated,including operation time,blood loss volume,postoperative complications,range of motion of elbow joint and Mayo elbow performance score(MEPS).Results:There was no statistical difference between group A and group B(P>0.05).After a mean follow-up of 24.6 months,elbow motion range in group A was better than that in group B(P<0.05).The score of motion in group A were higher,compared with group B(P<0.05).Mayo elbow performance in group A was lower in group A,with no stastistical difference(P>0.05).Conclusion:Both single approach and combined approach could achieve satisfactory effects.Single lateral approach seemed to associate with better motion range,lower ulnar damage and elbow stiffness than combined approach in treating triad of the elbow.