【摘要】：目的探討后外側入路聯合前內側入路治療肘關節(jié)恐怖三聯征的臨床效果。方法選取我院2014年10月—2016年10月,采用后外側入路聯合前內側入路治療肘關節(jié)恐怖三聯征患者18例。其中男14例,女4例;年齡22~56歲,平均40.75歲。左側5例,右側13例。橈骨頭骨折均以Hotchkiss改良的Mason分類法分類,均為Ⅳ型;尺骨冠狀突骨折以Regan-Morrey分類法分類:其中I型11例,Ⅱ型4例,Ⅲ型3例。受傷至手術時間1d~17d不等,平均為6d。術后隨訪,觀察并統計骨折愈合、軟組織修復、術后并發(fā)癥、肘關節(jié)評分及功能改善情況。結果本研究中的18例患者,均獲6-30個月隨訪,平均12.3個月。術前患者肘關節(jié)活動度:屈伸(63.5°±7.2°),前臂旋轉(73.5°±8.4°)。全部患者術后復查X線片均顯示骨折愈合,時間為8~13周,平均10.4周。均無術后感染及肘關節(jié)不穩(wěn)發(fā)生。末次隨訪時肘關節(jié)活動度為:屈伸(115.25°±9.6°),前臂旋轉(124.625°±12.03°)。末次隨訪MEPS評分結果:優(yōu)10例,良6例,可2例,無功能評分為差。與術前比較,差異有統計學意義(P0.05)。與健側相比屈伸(119±11.67°),旋轉(128.25±10.29°),差異沒有統計學意義(P0.05)。結論后外側入路聯合前內側入路治療肘關節(jié)恐怖三聯征,可恢復其骨與軟組織,使骨折愈合良好,明顯改善肘關節(jié)穩(wěn)定性,很大程度上改善其活動度,早期可行無痛(在鎮(zhèn)痛泵下)肘關節(jié)功能鍛煉,滿足日�；顒有枨�,療效滿意;此入路操作安全簡便,術區(qū)視野廣,暴露清楚,直視下操作更精細,便于復位與內固定,且不易損傷血管及神經,并能減少軟組織剝離,術后并發(fā)癥少,恢復良好。是臨床治療肘關節(jié)恐怖三聯征的有效手術方法,對臨床治療該類疾病具有指導意義。
[Abstract]:Objective to investigate the clinical effect of posterolateral approach combined with anterior medial approach in the treatment of triple elbow joint terror syndrome. Methods from October 2014 to October 2016, 18 cases of elbow terror triple sign were treated with posterolateral approach and anterior medial approach. Among them, 14 cases were male and 4 cases were female, the age was 2256 years old with an average of 40.75 years old. Left 5 cases, right 13 cases. The radial head fractures were classified by Hotchkiss's improved Mason classification, and the ulna coronal process fractures were classified by Regan-Morrey 's classification: 11 cases were type I, 4 cases were type 鈪，

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