一期修复治疗肘关节后外侧旋转不稳定的临床疗效观察

Observations on treatment effect of acute posterolateral rotatory instability of the elbow treated with the primary repair

目的观察一期修复肘关节外侧副韧带复合体治疗肘关节后外侧旋转不稳定的临床疗效。方法回顾性分析收治的31例肘关节脱位患者,其中简单脱位23例,复杂脱位8例。所有患者均合并肘关节后外侧旋转不稳定。其中16患者1期行切开探查并修复外侧副韧带复合体,15例患者1期予以肘关节铰链支具固定治疗,未行外侧副韧带复合体修复。对比2组患者Mayo肘关节功能评分(MEPS)、肘关节后外侧旋转不稳定试验(PLRI test)及肱桡比例,评价疗效。结果术后2组间MEPS评分、PLRI test比较,差异有统计学意义(P<0.05);术后2组间肱桡比例比较,非应力状态下差异无统计学意义(P>0.05),而应力状态下差异有统计学意义(P<0.05)。结论对于合并肘关节后外侧旋转不稳定的肘关节脱位患者,当恢复肘关节的骨性稳定结构后,一期修复肘关节后外侧副韧带复合体可明显改善肘关节功能,增加肘关节的后外侧旋转稳定性,进而降低慢性肘关节后外侧旋转不稳定发生率,同时可加速肘关节功能的恢复。

Objective To explore treatment effect of acute posterolateral rotatory instability(PLRI)of the elbow treated with the primary repair of lateral collateral ligament complex(LCLC).Methods A retrospective analysis was conducted of 31 patients with dislocation of the elbow,including 23 simple dislocations and 8 complex dislocations.All of them combined with posterolateral rotatory instability.16 patients underwent the primary repair of lateral collateral ligament complex,and 15 patients underwent the fixation of hinged brace without primary repair of lateral collateral ligament complex.Two groups of patients were compared with Mayo elbow function score(MEPS),elbow posterolateral rotation instability test(PLRI test)and brachial and radial ratio was evaluated.Results There was significant statistical difference in the MEPS score and the PLRI test after operation between two groups(P<0.05).There was no significant difference in the brachial and radial ratio between two groups under the non-stress condition(P>0.05),but significant statistical difference under the stress condition(P<0.05).Conclusion For patients combined with elbow posterolateral rotatory instability,after stabilizing the bone structure of elbow joint,the primary repair of lateral collateral ligament complex can improve function,enhance posterolateral rotatory instability and reduce instability incidence of elbow joint.Meanwhile,it can promote the recovery of the function of elbow joint.