手术治疗肘关节“恐怖三联征”15例

目的探讨＂恐怖三联征＂手术治疗方法及要点。方法对15例患者均采用了手术治疗。12例采用肘关节外侧入路结合肘前正中微型切口,3例采用肘外侧附加肘内侧手术入路,以微型螺钉及微型钢板固定粉碎性桡骨小头骨折,结合石膏、外固定架外固定。结果采用Mayo肘关节功能评分标准进行疗效评估。本组优4例,良8例,可2例,差l例,优良率80%。结论肘关节前侧关节囊、尺骨冠突和桡骨头对肘关节稳定性较为重要,辅助外固定尽量使用外固定架。

Discussion on surgical treating terrible triad elbow

Objective To explore the surgical approaches and the main operative points of surgical treatment of the terrible triad elbow. Methods 15 cases were treated with operation. 12 cases were operated with lateral approach combined with anterior median mini incision. 3 cases were operated with lateral approach combined with inner approach .The mini screws and mini plates were used to fix radial head fractures, and external fixture or external plaster fixation were used in the treatment. Results The results indicated that the excellent and improved rates were up to 80%. Four cases were improved greatly, 8 cases improved obviously, 2 cases improved, 1 case improved poorly with Mayo elbow score standard. Conclusion The joint capsule of front in elbow, the coronoid process of the ulna and the radial head are very important on the stability of elbow joint. The external fixture is superior to plaster fixation in clinical practices.