复杂性肘关节不稳

摘要(中文译文)

复杂性肘关节不稳由尺肱关节脱位并伴发一个或多个肘部骨性稳定结构骨折组成，这些结构包括桡骨头、尺骨近端、冠突或肱骨远端。复发性不稳通常不与单纯脱位相关，但处理不当的复杂脱位可能成为慢性、复发性肘关节不稳的前奏。复杂性不稳的处理难度显著高于单纯性不稳。与脱位相关的桡骨头、冠突和鹰嘴骨折均需评估，且常需手术治疗。复杂性肘关节损伤手术治疗的长期结局尚不明确。已发表的少数系列研究探讨了采用不同方法处理的不同损伤模式组合。然而，近期几项设计良好的前瞻性结局研究采用统一的治疗算法评估了几种不同个体骨折-脱位模式的处理。对损伤的骨性结构进行固定或置换、韧带修复以及铰链式固定可用于成功处理复杂性肘关节不稳。

Abstract

Complex elbow instability consists of dislocation of the ulnohumeral joint with a concomitant fracture of one or several of the bony stabilizers of the elbow, including the radial head, proximal ulna, coronoid process, or distal humerus. Recurrent instability is not often associated with simple dislocation, but an improperly managed complex dislocation may be a prelude to chronic, recurrent elbow instability. Complex instability is significantly more demanding to manage than simple instability. Radial head, coronoid, and olecranon fracture associated with dislocation each must be assessed and often require surgery. Long-term outcome with surgical management of complex elbow injuries is unknown. A few published series examine combinations of different injury patterns managed with various methods. Recently, however, several well-designed prospective outcome studies have evaluated management of several different individual fracture-dislocation patterns with a unified treatment algorithm. Fixation or replacement of injured bony elements, ligamentous repair, and hinged fixation may be used to successfully manage complex elbow instability.

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