全肘关节置换手术入路的选择与现状

全肘关节置换术最早主要用于治疗风湿性关节炎，但是随着近十几年来技术的进步，其适应证已扩大到创伤后不稳定、创伤性关节炎以及老年人新鲜肱骨远端骨折。但是其术后伤口感染、不愈合、尺神经损伤以及肱三头肌肌力下降等并发症一直是困扰临床骨科医师的问题。全肘关节置换术接受程度最为广泛的入路为Bryan-Morrey入路，近年保留肱三头肌鹰嘴附丽点的入路逐渐增多。本文回顾国内外全肘关节置换术相关的入路报道以及生物力学研究，对全肘关节置换手术入路的选择与现状做一综述。

Review and selection of the approach of total elbow arthroplasty

Total elbow arthroplasty was initially used to manage the rheumatoid arthritis of elbow. With the developement of technology in recent decades,the indication of total elbow arthroplasty include the trauma associated unstable joint,traumatic arthritis and distal humerus fractures in elderly. But the high risk of complications,which includes infection,ulnar nerve deficit and tricep insufficiency,is still an unsolved issue. The most widely used approach nowadays is the Bryan-Morrey approach,while some authors also report triceps on approach recently. This article is an overview in approaches and biomechanical researches of total elbow arthroplasy by reviewing the domestic and overseas involved literatures.