恐怖三联征的40例手术体会

目的：探讨微型钢板、可吸收棒联合肘关节铰链支架治疗肘关节恐怖三联征的临床效果。方法回顾性分析2011年1月至2013年6月间我科收治的40例恐怖三联征患者，按随机数字法分为对照组和观察组，每组20例，观察组采用内侧微型钢板、桡骨头可吸收钉棒联合肘关节铰链支架固定，对照组采用内外侧微型钢板治疗，术后佩戴支具1.5~2.0个月，评价肘关节功能，观察并发症发生情况。结果对照组术后3月、6月及1.5年评分低于观察组，两组差异有统计学意义（p<0.05）；末次随访观察组屈伸角度高于对照组（P<0.05），而旋转角度两组无统计学差异（P>0.05）；观察组骨折愈合时间为（3.4±0.5）月，对照组为（3.5±0.7）月，观察组骨折愈合时间与对照组比较差异无统计学意义（P<0.05）；观察组均未发生断钉、创伤性关节炎、肘关节不稳定、针道感染等并发症，对照组2例发生肘关节不稳，2例出现关节僵硬，推测为支具佩戴时间过长所致，1例发生断钉。结论微型钢板、可吸收棒联合肘关节铰链支架治疗肘关节恐怖三联征临床效果显著，术后肘关节稳定性好，骨折愈合佳，并发症低，是治疗恐怖三联征的可行术式。

The Experience of operation on 40 Cases of Terrible Triad

Objective To investigate theclinical effect ofmini plate,absorbablerodjointelbow hingestent in the treatment ofterri-ble triad of the elbow joint.Methods Retrospective analysis of 2011 January -2013year in Junein our departmenttreated 40 cases ofterrible triadpatients,randomLy divided into controlgroup and observation group,20 cases in each group,the observation groupby medialmini plate,radial headabsorbablescrew rodhingejointelbowbracket is fixed,the control grouptreated byinternal and externallat-eralmini plate,afterwearing theorthosis1.5~2.0 months,the function of the elbow,observe the occurence ofcomplication.Results Theobservation group after 3,June,1.5 yearsin control groupscores werelower than those in the observation group,the difference was statistically significant(P<0.05);the last follow-upobservation groupflexionangleis higher than that of control group(P<0.05),and the rotation anglehad no difference between the two groups (P>0.05);the healing time ofthe observationgroup is 3.2 +0.4 months offrac-ture,the controlgroup is 3.4+0.6months,with no significant difference between two groups (P<0.05).The observation groupwere not-broken,traumatic arthritis,elbow joint instability,pin tract infectionand other complicationsoccurred in 2 cases,control group2 cases ofelbowjoint instability,joint stiffness,presumablybracewornfor too long of a time,1cases ofbroken.Conclusion Mini plate,ab-sorbable rodjointelbow hingestent in the treatment ofterrible triad ofthe elbow jointsignificant clinical effect,postoperativeelbow jointhas good stability,goodfracture healing,complicationsislow,the treatmentof terrible triad of thefeasibleoperation.