冠状突骨折内固定联合桡侧副韧带修复治疗肘关节后内侧旋转不稳定的临床疗效

doi:10.13418/j.issn.1001-165x.2025.4.04

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中国临床解剖学杂志 ›› 2025, Vol. 43 ›› Issue (4) : 387-391. DOI: 10.13418/j.issn.1001-165x.2025.4.04

肘关节运动损伤诊疗策略

冠状突骨折内固定联合桡侧副韧带修复治疗肘关节后内侧旋转不稳定的临床疗效

潘超，闫兵山，刘俊阳，韩磊，张博，田旭，刘林涛，东靖明*

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Clinical efficacy of coronoid fixation combined with lateral radial collateral ligament repair in the elbow posteromedial rotational instability

Pan Chao, Yan Bingshan, Liu Junyang, Han Lei, Zhang Bo, Tian Xu, Liu Lintao, Dong Jingming*

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摘要

目的比较冠状突骨折内固定伴或不伴桡侧副韧带（LRCL）修复治疗肘关节后内侧旋转不稳定（PMRI）的临床疗效。方法回顾性分析2015年1月至2023年6月间符合标准的33例PMRI患者资料。15例患者接受单纯冠状突骨折内固定，18例患者行冠状突骨折内固定联合桡侧副韧带修复，对两组围手术期资料、肘关节功能及并发症发生情况进行比较。结果所有患者随访时间16~52个月，平均随访33.5个月。单纯固定组在手术时间、术中出血量方面优于联合LRCL修复组，差异有显著性意义（P<0.05）。LRCL联合修复组的屈肘及伸肘角度优于单纯固定组（P<0.05），但两组患者的旋前、旋后角度无组间差异（P>0.05）。至末次随访，LRCL联合修复组的MEPS评分及DASH评分均优于单纯固定组，差异具有统计学意义（P<0.05）；两组患者末次随访VAS评分组间差异无统计学意义（P>0.05）。LRCL联合修复组1例患者出现外侧伤口愈合不良，两组患者分别有2例患者出现尺神经麻木症状，两组患者并发症发生率和Hastings＆Graham异位骨化分级组间差异无统计学意义（P>0.05）。结论对于合并肱桡关节脱位和半脱位的PMRI患者，冠状突骨折内固定联合LRCL修复可显著改善肘关节的活动度和功能评分，且不会增加并发症及异位骨化发生风险。

Abstract

Objective To compare the clinical efficacy of coronoid fixation with or without lateral radial collateral ligament (LRCL) repair in the elbow posteromedial rotational instability (PMRI). Methods The data of 33 PMRI patients who met the criteria from January 2015 to June 2023 were retrospectively analyzed. Fifteen patients underwent simple internal fixation of coronal process fractures, while 18 patients underwent coronoid fixation combined with LRCL repairing. The perioperative data, elbow joint function, and incidence of complications were compared between the two groups. Results All patients were followed up for 16 to 52 months, with an average follow-up of 33.5 months. The fixed group was superior to the LRCL repair group in terms of surgical time and intraoperative blood loss, and the difference was statistically significant (all P<0.05). The LRCL repair group had better elbow flexion and extension angles than the simple fixation group (both P<0.05), but there was no statistically significant difference between the two groups in terms of pronation and supination angles (both P>0.05). At the last follow-up, the LRCL repair group had better MEPS and DASH scores than the fixed group, and the difference was statistically significant (both P<0.05). There was no significant difference in VAS scores between the two groups (P>0.05). One patient in the LRCL repair group experienced poor healing of the lateral wound, and two patients in each group showed symptoms of ulnar nerve numbness. There was no statistically significant difference in the incidence of complications and Hastings&Graham ectopic ossification grading between the two groups of patients (both P>0.05). Conclusions For PMRI patients with subluxation or dislocation in the humeroradial joint, LRCL repairing can significantly improve elbow joint range of motion and functional scores but not increasing the risk of complications and ectopic ossification.

导出引用

潘超, 闫兵山, 刘俊阳, 韩磊, 张博, 田旭, 刘林涛, 东靖明. 冠状突骨折内固定联合桡侧副韧带修复治疗肘关节后内侧旋转不稳定的临床疗效[J]. 中国临床解剖学杂志. 2025, 43(4): 387-391 https://doi.org/10.13418/j.issn.1001-165x.2025.4.04

Pan Chao, Yan Bingshan, Liu Junyang, Han Lei, Zhang Bo, Tian Xu, Liu Lintao, Dong Jingming. Clinical efficacy of coronoid fixation combined with lateral radial collateral ligament repair in the elbow posteromedial rotational instability [J]. Chinese Journal of Clinical Anatomy. 2025, 43(4): 387-391 https://doi.org/10.13418/j.issn.1001-165x.2025.4.04

中图分类号： R683.41

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