单一外侧切口和内外侧双切口治疗肘关节三联征的对比研究
Comparative study of single lateral incision and combined lateral and medial incisions for treatment of terrible triad of the elbow
目的 探讨单一外侧切口和内外侧双切口治疗肘关节三联征的疗效. 方法 采用回顾性队列研究分析2010年7月一2013年6月手术治疗的57例肘关节三联征患者,按手术入路分为单一外侧切口(A组,32例)和内外侧双切口(B组,25例).A组男21例,女11例;年龄(40.2±3.3)岁.B组男18例,女7例;年龄(39.1±2.6)岁.比较两组手术时间、术中出血量、术后并发症、肘关节活动度、Mayo肘关节功能评分(MEPS)、Hastings & Graham异位骨化分级等.结果 两组手术时间、术中出血量差异无统计学意义(P>0.05).B组尺神经损伤、握力下降发生率较A组高(P<0.05).平均随访时间25.9个月,A组肘关节屈伸、前臂旋转活动度[(123.4_+6.5).、(167.5±6.0)°]显著优于B组[(84.9±27.2)°、(136.5±8.5)°](P<0.01).A组MEPS总分[(95.8±1.2)分]显著高于B组[(84.9±3.1)分](P<0.01).B组异位骨化较A组严重(P<0.01).结论 单一外侧切口较内外侧双切口可获得更好的功能结果,术后异位骨化发生率也更低.
更多Objective To investigate the clinical outcomes of terrible triad of the elbow treated with single lateral incision versus combined lateral and medial incisions.Methods This retrospective cohort research involved 57 patients with terrible triad of the elbow operated between July 2010 and June 2013.According to the surgical approaches,the patients were assigned to single lateral incision (Group A,n =32) and combined lateral and medial incisions (Group B,n =25).Group A consisted of 21 males and 11 females,with a mean age of (40.2 ± 3.3) years.Group B consisted of 18 males and seven females,with a mean age of (39.1 ± 2.6) years.Operation time,blood loss,postoperative complications,elbow range of motion,Mayo elbow performance score (MEPS) and Hastings and Graham heterotopic ossification classification were compared between groups.Results There were no significant differences in operation time and blood loss between Group A and B (P > 0.05).Incidence of ulnar nerve injury and strength decrease were higher in Group A than Group B (P<0.05).Mter a mean follow-up of 25.9 months,elbow extension-flexion and forearm pronation-supination in Group A [(123.4 ± 6.5) ~,(167.5 ± 6.0) °] were better than those in group B [(84.9 ± 27.2) °,(136.5 ± 8.5)°] (P < 0.01),and MEPS in Group A [(95.8 ± 1.2) points] was also better than that in Group B [(84.9 ± 3.1) points] (P < 0.01).Heterotopic ossification was more serious in Group B than Group A (P < 0.01).Conclusion Single lateral incision is associated with better function and lower rate of heterotopic ossification than combined lateral and medial incisions in treating terrible triad of the elbow.
More- 浏览:151
- 被引:7
- 下载:306
相似文献
- 中文期刊
- 外文期刊
- 学位论文
- 会议论文