• 临床论丛 • 上一篇    下一篇

肘关节恐怖三联征的手术治疗体会

韩立强   

  1. 天津市第三中心医院骨科
  • 收稿日期:2010-12-03 修回日期:2011-04-04 出版日期:2011-10-15 发布日期:2011-10-15
  • 通讯作者: 韩立强

Operative treatment of the terrible triad of the elbow

  • Received:2010-12-03 Revised:2011-04-04 Published:2011-10-15 Online:2011-10-15

摘要: 目的:回顾分析肘关节恐怖三联征手术治疗的临床疗效。方法:2009年1月至2010年9月,我科收治7例肘关节恐怖三联征患者,男6例,女1例,年龄24—36岁,致伤原因:高处坠落伤5例,摔伤1例,车祸伤1例。尺骨冠状突骨折采用Regan-Morrey分型:本组病例Ⅰ型1例,Ⅱ型6例; 桡骨小头骨折采用Mason分型:Ⅰ型1例,Ⅱ型3例,Ⅲ型2例,1例合并有桡骨颈骨折。所有患者均行手术治疗,术中修复冠状突骨折、前关节囊、桡骨小头骨折及桡、尺侧副韧带,术后行石膏托固定,采用Mayo肘关节功能评分进行评价。结果:7例患者手术切口均一期愈合。所有患者均得到随访,随访时间5—15个月,,平均11.2个月。按Mayo肘关节功能评分标准:优3例,良2例,可1例,差1例。1例发生骨化性肌炎。结论: 肘关节恐怖三联征造成肘关节严重不稳,保守治疗无效,均应行手术治疗,尽可能修复骨性结构及周围韧带组织,重建肘关节稳定性,术后早期功能锻炼,可最大程度的恢复肘关节功能。

关键词: 恐怖三联征, 肘关节, 手术, 功能重建

Abstract: Objective : To retrospectively reviewed the operative therapy of the terrible triad of the elbow. Methods: From January 2009 to September 2010, 7 cases of terrible triad of the elbow were treated, with an elbow dislocation and an associated fracture of both the radial head and the coronoid process. There were 6 males and 1 females with the age of 24-36 years. The injury was caused by falling from a height in 5 cases, traffi c accidents in 1 case, and tumbling in 1 case. The coronoid process fractures of the patients were 1 cases of type I, 6 cases of type II according to Regan-Morrey classification. The radial head fractures of the patients were 1 case of type I, 3 cases of type II and 2 case of type III according to Mason classifi cation, and 1 case companied with radial neck fracture.All the patients were treated with operation. coronoid process fracture,. radial head fracture and medial collateral ligaments were repaired in operation. Postoperatively, plaster fixation were given. The function of the elbows were evaluated with the criteria of the Mayo score system. Results: The wounds healed by first intention. The patients were followed up 5 to 15 mouths (mean 11.2 months). According to the criteriaof the Mayo score, the results were excellent in 3 cases, good in 2 cases, poor in 1 case, bad in 1 case. Ossification occurred in 1 patient. Conclusion: The terrible triad of the elbow can lead to serious elbow instability and should be treated with operation to restore the bone and soft structures, early exercise can avoid immobilization and recover the articular function.

Key words: Terrible triad fracture, Elbow joint, Operation, Function reconstruction