肱三头肌肌腱重建环状韧带治疗青少年创伤性桡骨头脱位

目的讨论肱三头肌肌腱重建环状韧带治疗青少年创伤性桡骨头脱位的手术疗效,为临床治疗提供依据。方法回顾性分析解放军第59中心医院2011年5月—2016年9月收治的15例青少年创伤性桡骨头脱位患者,应用肱三头肌肌腱重建环状韧带治疗,男性9例,女性6例;年龄8~18岁,平均14.6岁。道路交通伤8例,摔伤7例;其中桡骨头脱位伴尺骨近段骨折6例,所有病例无神经损伤,无桡骨头骨折。结果 15例青少年患者术后均无手术感染,术后3~24个月内复查,通过Macky肘关节评分及Barthel指数评价疗效,治疗整体效果满意。结论肱三头肌肌腱重建环状韧带治疗青少年创伤性桡骨头脱位手术方式,患者术后肘关节功能活动恢复良好,手术方法简单有效,值得在临床工作中进行推广。

Effectiveness of annular ligament reconstruction using the triceps tendon in the treatment of traumatic radial head dislocation in adolescents

Objective To discuss the surgical effect of annular ligament reconstruction using the triceps tendon in the treatment of traumatic radial head dislocation in adolescents,thus providing evidence for the clinical treatment.Methods A retrospective analysis was conducted for 15 adolescent patients suffering traumatic injuries with or without radial head dislocation,who were admitted to the 59th Hospital of Chinese PLA between May 2011 and Sept.2016 and treated by annular ligament reconstruction using the triceps tendon.The patients were aged be-tween 8 and 18 years,with a mean age of 14.6 years.There were 8 cases of traffic injury and 7 cases of falling inju-ry.Six of the 15 adolescent patients were complicated by radial head dislocation with proximal ulnar fracture,and no patient was complicated by radial nerve injury or radial head fracture.Results None of the 15 adolescent patients suffered surgical infection after annular ligament reconstruction.The overall therapeutic effect was satisfactory as ev-idenced by assessment of Macky elbow performance score and Barthel Index performed within 3 to 24 months after the surgery.Conclusion Annular ligament reconstruction using the triceps tendon is effective in the treatment of traumatic radial head dislocation in the adolescent patients and the patients 'elbow function recovers well after the surgery.This surgical approach is simple and effective and worthy of promotion in clinical practice.