两种不同的复杂创伤肘部不稳定模式之间的结果和并发症的差异. 一个可怕的三位一体和olecranon骨折位移的回顾性比较
Ashok S Gavaskar1, Naveen C Tummala2, Parthasarathy Srinivasan1
1Rela Institute and Medical Centre, Chennai, India.
JSES international
|June 9, 2025
概括
对可怕的三角形 (TT) 肘部损伤和骨头骨折脱位 (OFD) 的手术治疗产生了良好的结果. 虽然TT损伤显示出更好的运动,但这两种情况的并发症率和功能评分相似,尽管OFD患有更多的关节炎.
科学领域:
- 整形外科手术 整形外科手术
- 创伤外科 手术 创伤外科
- 肘部生物力学 肘部生物力学
背景情况:
- 可怕的三角形 (TT) 和骨头骨折脱位 (OFD) 是严重的肘部不稳定性.
- 尽管有不同的机制,但结构损伤和处理原则重叠.
- 结果的比较在创伤性肘部不稳定性方面具有临床意义.
研究的目的:
- 为了比较TT与OFD的手术治疗后的功能结果和并发症.
- 分析运动范围,关节稳定性和并发症率.
- 评估修复手术的需要.
主要方法:
- 在2012-2021年间进行手术治疗的79名患者 (TT:44,OFD:35) 的回顾性审查.
- 评估肘部/前臂运动范围和关节稳定性.
- 通过MEPS,牛津肘部得分和QuickDASH测量功能的结果.
主要成果:
- TT组表现出更好的曲-延伸弧和更少的延伸缺陷;OFD组的 supination 较少.
- 功能评分,并发症发生率和重新手术率相似.
- 肘部关节炎在OFD组中更频繁 (P=.03).
- 84% (TT) 和86% (OFD) 实现了良好的至优秀的MEPS.
结论:
- 手术治疗为TT和OFD伤害提供了良好的结果.
- 并发症很常见 (>40%),通常需要二次手术 (>25%).
- 在OFD患者手术后,肘部关节炎的发病率较高.
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