桡骨头切除对肘关节稳定性影响的生物力学研究

目的：探讨桡骨头粉碎性骨折不同治疗方法对肘关节稳定性的影响。方法：将10个尸体标本，分别测定在其它组织无损伤时，肘内侧副韧带切断时，肘内侧副韧带和前臂骨间膜均切断时的力－位移曲线（纵向位移）及肘外翻角。结果：肘内侧副韧带切断时的纵向位移及肘外翻角均大于其它组织无损伤时；肘内侧副韧带和前臂骨间膜均切断时的纵向位移及肘外翻角均大于其它组织无损伤时和肘内侧副韧带切断时，两两间比较均有显著性差异（P＜0．001）。结论：在其它组织无损伤时，单纯桡骨头切除是安全的；合并肘内侧副韧带损伤时，可在有效修补韧带的同时作单纯头切除，必要时行假体置换；合并肘内侧副韧带和前臂骨间膜均损伤时，最好作假体置换。

Biomechanical Research of Resection of Radial Head on Stability of Elbow Joint

Objective: To evaluate the effects of different treatments of radial head fractures on stability of elbow joint by biomechanical research. Methods: The ten specimens of cadavers, to test the displacement and cubitus valgus angle of the other tissue no injury, cut medial collateral ligament of elbow and cut the medial collaeral and interosseou ligment of forearm. Respectively. Results: The vertical displacement and elbow evaginate angle of the cut medial collateral ligament were larger than that of the other tissue no injury, the vertical displacement and cubitus valgus angle of the cut the medial collaeral and interosseou ligment of forearm were larger than the other tissue no injury and the cut medial collateral ligament, there were significant difference among them(P<0.001). Conclusions: It is safe way to only resect the radial head in case of other tissue no injury; and with the injury of the elbow medial collateral ligament, it also do this excision and restore the ligament simultaneously, prosthesis replacementis is recommended if necessory; with the injury of the elbow medial collaeral and interosseou ligment of forearm, it is the best method to do prosthesis replacement. Key words Resection of radial head; Elbow joint; Biomechanics; Researchno death. However, there were 2 cases with kidney function failure and 7 with amputation. Successful reconstruction was carried out in 62 cases. Of 43 cases followed up for mean 3.1 years, 4 cases were found with bone nonunion. Conclusions There is a higher rate of misdiagnosis and shock complication in those with fractures and/or dislocations complicated by major vascular injuries in extremities than those with single fractures. The principle of the management is life prior to extremities. The rigid fixation of fractures and/or dislocation and the repair of the vascular injuries should be used together so as to attain a satisfactory outcome.