摘要
目的探讨难复性肘关节脱位合并肱动脉损伤的治疗策略。方法回顾性分析自2015-03—2018-06行手术切开修复治疗的7例单纯肘关节脱位合并肱动脉损伤,一期行肘关节骨性结构的恢复与软组织稳定的重建,同时行血管移植恢复肱动脉的连续性,二期行游离皮片移植关闭伤口。结果7例均顺利完成手术并获得完整随访,随访时间6~24个月,平均14.5个月。末次随访时肘关节X线片显示7例均获得并维持同心圆复位。1例出现肘关节关节囊及韧带处异位骨化,对症治疗后治愈。无肘关节不稳定、无切口或针道感染发生。末次随访时Mayo肘关节功能评分:优5例,良1例,可1例。结论难复性肘关节脱位合并肱动脉损伤通过一期肘关节骨结构与软组织稳定重建、恢复肱动脉连续性,二期行游离植皮,并结合早期康复锻炼可获得满意疗效。
Objective To explore the treatment strategy of irreducible elbow dislocation with brachial artery injury.Methods From March 2015 to June 2018,7 cases of simple dislocation of elbow joint with brachial artery injury were retrospectively analyzed.The first stage operation was performed to restore bone structure and soft tissue stability of elbow joint and recover the continuity of brachial artery by vascular transplantation,and the second stage operation for closure of the wound by free skin graft.Results All of the 7 patients completed the operation successfully and were followed up for 6-24 months,with an average of 14.5 months.At the last follow-up,the X-ray of elbow joint showed that 7 cases all obtained and maintained concentric circle reduction.One case had heterotopic ossification of the joint capsule and ligament of elbow joint,which was cured after treatment.There was no instability of elbow joint,no incision or needle infection.At the last follow-up,the Mayo Elbow function score was excellent in 5 cases,good in 1 case,and moderate in 1 case.Conclusion The treatment of irreducible dislocation of elbow joint combined with brachial artery injury can achieve satisfactory results through the first stage reconstruction of bone structure and soft tissue of elbow joint,restoration of continuity of brachial artery,and the second stage free skin grafting and early rehabilitation exercise.
作者
贾宗海
梁高峰
耿朝萌
张满盈
韩瑞旸
段超鹏
何俊娥
张朝
郭永明
滕云升
JIA Zong-hai;LIANG Gao-feng;GENG Zhao-meng;ZHANG Man-ying;HAN Rui-yang;DUAN Chao-peng;HE Jun-e;ZHANG Zhao;GUO Yong-ming;TENG Yun-sheng(Department of Upper Linb and Hand Surgery,Chinese Military Industry 521 Hospital,Xi'an,Shaanxi 710065,China)
出处
《中国骨与关节损伤杂志》
2020年第5期464-466,共3页
Chinese Journal of Bone and Joint Injury
关键词
难复性肘关节脱位
肱动脉损伤
血管移植
游离皮片移植
Irreducible dislocation of elbow joint
Brachial artery injury
Vascular transplantation
Free skin graft
