手术治疗肘关节恐怖三联征的临床疗效观察及体会

目的观察手术治疗肘关节恐怖三联征的临床疗效及治疗体会。方法自2008-05—2012-03诊治肘关节恐怖三联征38例,桡骨头骨折Mason分型：Ⅱ型28例,Ⅲ型10例;按Johnston-Mason分型因合并肘关节的脱位38例均为Ⅳ型;尺骨冠状突骨折Regan-Morrey分型：Ⅰ型8例,Ⅱ型17例,Ⅲ型13例。38例均在臂丛神经阻滞麻醉下切开复位内固定联合修复关节周围韧带。结果所有患者获得随访6-18个月,平均12个月。随访观察X线片及患肢活动情况,采用Mayo肘关节评分方法评估：优23例,良9例,可5例,差1例,优良率84.2%,肘关节功能恢复可。结论肘关节恐怖三联征为高能量损伤、伴有侧副韧带损伤,对肘关节功能影响明显,早期行手术治疗重建骨与关节周围的软组织结构稳定,同时配合术后功能锻炼,可恢复到较好的功能。

Clinical curative effect observation and experience of surgery for terrible triad of elbow

Objective To observe the clinical curative effect and experience of surgical treatment of terrible triad of the elbow. Methods A total of 38 consecutive patients with the terrible triad of the elbow were treated from May 2008 to March 2008. According to Mason classification, radial head fractures were type II in 28 cases, and type III in 10 cases （Aceording to Johnston-Mason classification 38 patients were typelV, due to the merger of elbow dislocation）. Coronoid fracture were type I 8 cases, II 17 cases, HI 13 cases according to Regan-Morrey classification. Thirty eight cases were under braehial plexus block anesthesia performed joint repair elbow ligaments around the open reduction and internal fixation. Results All patients were followed up for 6-18 months, an average of 12 months. Follow-up included X-ray and limb activity examination. Mayo elbow scoring method were evaluated. The results was excellent in 23 cases, good in 9 cases, fair 5 in cases, bad in 1 case, the excellent and good rate was 84.2%. The elbow joint function recovered. Conclusion The terrible triad of the elbow with high-energy injuries, accompanied by lateral collateral ligament injury at the same time, impact on the function of elbow joint and unstable. Early reconstruction of the stability of bone and joint soft tissue structure and postoperative functional exercise, can achieve good function.