前向鷹嘴骨折脫位的手術治療_《中國修復重建外科雜志》

作者：

胡曉川 , 向明 , 陳杭 , 楊順 , 唐浩琛 , 楊國勇

四川省骨科醫院上肢創傷科（成都，610041）;

關鍵詞：

肘關節前向鷹嘴骨折脫位內固定

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目的探討手術治療前向鷹嘴骨折脫位的方法及臨床療效。方法回顧分析2007年1月－2010年12月收治且獲完整隨訪的10例前向鷹嘴骨折脫位患者臨床資料。男6例，女4例；年齡27～68歲，平均46.1歲。交通事故傷7例，高處墜落傷2例，跌傷1例。新鮮骨折9例，陳舊性骨折1例。尺骨鷹嘴粉碎性骨折9例，斜形骨折l例。合并Regan-Morrey Ⅲ型冠狀突骨折5例，MasonⅡ型和Ⅲ型橈骨頭骨折各1例。行切開復位內固定，其中采用重建鋼板4 例，張力帶加重建鋼板5例，張力帶加1/3管狀鋼板1例；2例行一期植骨。結果術后切口均Ⅰ期愈合。患者均獲隨訪，隨訪時間12～26個月，平均19.8個月。X線片檢查示骨折均愈合，愈合時間12～24周，平均16.4周；隨訪期間無內固定失效、肱尺關節不穩定、創傷后關節炎發生。末次隨訪時，肘關節功能根據Broberg-Morrey功能評價標準評分為69～100分，平均89.1分；獲優4例，良4例，可2例，優良率80%。上肢功能評定表（DASH）評分為0～22分，平均9分。疼痛視覺模擬評分（VAS）為0～3分，平均0.5分。結論對于前向鷹嘴骨折脫位，應用鋼板進行堅強內固定、解剖重建滑車切跡及術后早期主動活動鍛煉，可獲得滿意療效。

引用本文： 胡曉川,向明,陳杭,楊順,唐浩琛,楊國勇. 前向鷹嘴骨折脫位的手術治療. 中國修復重建外科雜志, 2012, 26(12): 1462-1465. doi: 復制

1.	Ring D, Jupiter JB, Sanders RW, et al. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma, 1997, 11(8): 545-550.
2.	Mouhsine E, Akiki A, Castagna A, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg, 2007, 16(3): 352-357.
3.	Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg (Am), 1986, 68(5): 669-674.
4.	Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med, 1996, 29(6): 602-608.
5.	陳振兵, 洪光祥, 王發斌. 上肢功能評定表. 中國修復重建外科雜志, 2004, 18(6): 520-521.
6.	Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg (Am), 1998, 80(4): 566-580.
7.	蔣協遠, 王滿宜, 黃強, 等. 尺骨鷹嘴骨折合并肘關節前脫位的手術治療. 中華骨科雜志, 2000, 20(3): 154-156.
8.	Bucholz RW. 洛克伍德-格林成人骨折. 6版. 裴國獻, 譯. 北京: 人民軍醫出版社, 2009: 875.
9.	Lindenhovius AL, Brouwer KM, Doornberg JN, et al. Long-term outcome of operatively treated fracture-dislocations of the olecranon. J Orthop Trauma, 2008, 22(5): 325-331.
10.	Doornberg J, Ring D, Jupiter JB. Effective treatment of fracture-dislocations of the olecranon requires a stable trochlear notch. Clin Orthop Relat Res, 2004, (429): 292-300.
11.	Jupiter JB, Leibovic SJ, Ribbans W, et al. The posterior Monteggia lesion. J Orthop Trauma, 1991, 5(4): 395-402.
12.	Ring D, Jupiter JB, Simpson NS. Monteggia fractures in adults. J Bone Joint Surg (Am), 1998, 80(12): 1733-1744.
13.	Ruedi TP, Buckley R, Moran C. 骨折治療的AO原則. 危杰, 劉璠, 吳新寶, 等譯. 上海: 上海科學技術出版社, 2010: 476.
14.	李庭, 蔣協遠, 張健, 等. 成人尺骨近端向后孟氏損傷的診斷與治療. 中華外科雜志, 2009, 47(12): 899-902.
15.	滕林, 鐘剛, 肖聰, 等. 重建鋼板聯合張力帶治療尺骨上段合并鷹嘴骨折. 中國修復重建外科雜志, 2011, 25(1): 17-20.
16.	Mortazavi SM, Asadollahi S, Tahririan MA. Functional outcome following treatment of transolecranon fracture-dislocation of the elbow. Injury, 2006, 37(3): 284-288.
17.	Siebenlist S, Torsiglieri T, Kraus T, et al. Comminuted fractures of the proximal ulna—Preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury, 2010, 41(12): 1306-1311.
18.	Buijze GA, Blankevoort L, Tuijthof GJ, et al. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg, 2010, 130(4): 459-464.
19.	Ochtman AE, Ring D. Combined posterior and medial plate fixation of complex proximal ulna fractures. Injury, 2012, 43(2): 254-256.
20.	McKay PL, Katarincic JA. Fractures of the proximal ulna olecranon and coronoid fractures. Hand Clin, 2002, 18(1): 43-53.

1. Ring D, Jupiter JB, Sanders RW, et al. Transolecranon fracture-dislocation of the elbow. J Orthop Trauma, 1997, 11(8): 545-550.
2. Mouhsine E, Akiki A, Castagna A, et al. Transolecranon anterior fracture dislocation. J Shoulder Elbow Surg, 2007, 16(3): 352-357.
3. Broberg MA, Morrey BF. Results of delayed excision of the radial head after fracture. J Bone Joint Surg (Am), 1986, 68(5): 669-674.
4. Hudak PL, Amadio PC, Bombardier C. Development of an upper extremity outcome measure: the DASH (disabilities of the arm, shoulder and hand) [corrected]. The Upper Extremity Collaborative Group (UECG). Am J Ind Med, 1996, 29(6): 602-608.
5. 陳振兵, 洪光祥, 王發斌. 上肢功能評定表. 中國修復重建外科雜志, 2004, 18(6): 520-521.
6. Ring D, Jupiter JB. Fracture-dislocation of the elbow. J Bone Joint Surg (Am), 1998, 80(4): 566-580.
7. 蔣協遠, 王滿宜, 黃強, 等. 尺骨鷹嘴骨折合并肘關節前脫位的手術治療. 中華骨科雜志, 2000, 20(3): 154-156.
8. Bucholz RW. 洛克伍德-格林成人骨折. 6版. 裴國獻, 譯. 北京: 人民軍醫出版社, 2009: 875.
9. Lindenhovius AL, Brouwer KM, Doornberg JN, et al. Long-term outcome of operatively treated fracture-dislocations of the olecranon. J Orthop Trauma, 2008, 22(5): 325-331.
10. Doornberg J, Ring D, Jupiter JB. Effective treatment of fracture-dislocations of the olecranon requires a stable trochlear notch. Clin Orthop Relat Res, 2004, (429): 292-300.
11. Jupiter JB, Leibovic SJ, Ribbans W, et al. The posterior Monteggia lesion. J Orthop Trauma, 1991, 5(4): 395-402.
12. Ring D, Jupiter JB, Simpson NS. Monteggia fractures in adults. J Bone Joint Surg (Am), 1998, 80(12): 1733-1744.
13. Ruedi TP, Buckley R, Moran C. 骨折治療的AO原則. 危杰, 劉璠, 吳新寶, 等譯. 上海: 上海科學技術出版社, 2010: 476.
14. 李庭, 蔣協遠, 張健, 等. 成人尺骨近端向后孟氏損傷的診斷與治療. 中華外科雜志, 2009, 47(12): 899-902.
15. 滕林, 鐘剛, 肖聰, 等. 重建鋼板聯合張力帶治療尺骨上段合并鷹嘴骨折. 中國修復重建外科雜志, 2011, 25(1): 17-20.
16. Mortazavi SM, Asadollahi S, Tahririan MA. Functional outcome following treatment of transolecranon fracture-dislocation of the elbow. Injury, 2006, 37(3): 284-288.
17. Siebenlist S, Torsiglieri T, Kraus T, et al. Comminuted fractures of the proximal ulna—Preliminary results with an anatomically preshaped locking compression plate (LCP) system. Injury, 2010, 41(12): 1306-1311.
18. Buijze GA, Blankevoort L, Tuijthof GJ, et al. Biomechanical evaluation of fixation of comminuted olecranon fractures: one-third tubular versus locking compression plating. Arch Orthop Trauma Surg, 2010, 130(4): 459-464.
19. Ochtman AE, Ring D. Combined posterior and medial plate fixation of complex proximal ulna fractures. Injury, 2012, 43(2): 254-256.
20. McKay PL, Katarincic JA. Fractures of the proximal ulna olecranon and coronoid fractures. Hand Clin, 2002, 18(1): 43-53.

《中國修復重建外科雜志》

前向鷹嘴骨折脫位的手術治療

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《中國修復重建外科雜志》

前向鷹嘴骨折脫位的手術治療

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

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