肘关节后外侧旋转不稳复发性后小头缺损的修复。

IF 1.8 Q2 ORTHOPEDICS
Dani Rotman, Jorge Rojas Lievano, Shawn W O'Driscoll
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引用次数: 1

摘要

背景:后外侧旋转不稳定(PLRI)是复发性肘关节不稳定的常见机制。虽然主要病变是外侧尺侧副韧带(LUCL)缺陷,但通常伴有骨病变,如osborn - cotterill病变(后小头骨折)和桡骨头边缘骨折,会损害稳定性。目前,对于复发性PLRI相关的后小头骨缺损尚无标准治疗方法。方法:我们对5例在正常活动范围内肘关节复发性PLRI合并桡骨头后小头嵌塞骨折的患者进行回顾性分析。手术治疗患者采用LUCL重建或修复,并使用设计用于跖骨头置换的小型金属假体(HemiCAP脚趾经典)进行小头关节表面的非适应症重建。结果:2007 - 2018年共收治5例患者(3例青少年男性,2例成年女性)。在中位5年的随访中,所有患者的症状不稳定都得到了完全缓解。没有患者在休息时出现疼痛,但有2例患者在运动时出现轻度疼痛(视觉模拟评分1-3)。3名患者认为肘部正常,1名认为几乎正常,1名认为有很大改善。在短期的x线随访中,没有发现植入物松动的迹象。所有患者均无需再手术。结论:肘关节复发性PLRI合并后小头病变可通过LUCL重建、修复和金属假体填充小头缺损成功治疗。这种治疗方案在中短期内具有良好的临床效果。证据等级:四级。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow.

Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow.

Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow.

Prosthetic resurfacing of engaging posterior capitellar defects in recurrent posterolateral rotatory instability of the elbow.

Background: Posterolateral rotatory instability (PLRI) is a common mechanism of recurrent elbow instability. While the essential lesion is a deficiency in the lateral ulnar collateral ligament (LUCL), there are often associated concomitant bony lesions, such as an Osborne-Cotterill lesions (posterior capitellar fractures) and marginal radial head fractures, that compromise stability. Currently, there is no standard treatment for posterior capitellar deficiency associated with recurrent PLRI.

Methods: We conducted a retrospective review of five patients with recurrent PLRI of the elbow associated with a posterior capitellar impaction fracture engaging with the radial head during normal range of motion. The patients were treated surgically with LUCL reconstruction or repair and off-label reconstruction of the capitellar joint surface using a small metal prosthesis designed for metatarsal head resurfacing (HemiCAP toe classic).

Results: Five patients (three adolescent males, two adult females) were treated between 2007 and 2018. At a median follow-up of 5 years, all patients had complete relief of their symptomatic instability. No patients had pain at rest, but two patients had mild pain (visual analog scale 1-3) during physical activity. Three patients rated their elbow as normal, one as almost normal, and one as greatly improved. On short-term radiographic follow-up there were no signs of implant loosening. None of the patients needed reoperation.

Conclusions: Recurrent PLRI of the elbow associated with an engaging posterior capitellar lesion can be treated successfully by LUCL reconstruction and repair and filling of the capitellar defect with a metal prosthesis. This treatment option has excellent clinical results in the short-medium term. Level of evidence: IV.

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CiteScore
0.30
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审稿时长
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