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Isolated displaced type II partial articular radial head fracture: correlation of preoperative imaging with intraoperative findings of lateral ulnar collateral ligament tear.

孤立性移位 ⅱ 型部分关节桡骨头骨折: 术前影像学与外侧尺侧副韧带撕裂术中所见的相关性。

  • 影响因子:3.05
  • DOI:10.1016/j.jse.2019.07.006
  • 作者列表:"Tarallo L","Porcellini G","Merolla G","Pellegrini A","Giorgini A","Catani F
  • 发表时间:2020-01-01
Abstract

BACKGROUND:The aim of this study was to determine the lateral ulnar collateral ligament (LUCL) injury associated with isolated radial head fracture (RHF) and the relationship of the ligament injury with the displacement of the fragment-loss of contact-in unstable displaced partial articular RHF in individuals without any history of ulnohumeral dislocation. METHODS:We retrospectively identified 131 consecutive patients who underwent open reduction and internal fixation of isolated closed Mason type II RHF performed at our institution. We identified 3 subsets by the pattern of RHF and the position of the unstable fragment (anterior or posterior) relative to the capitulum humeri: displaced stable (group I), displaced anterior unstable (group II), and displaced posterior unstable (group III). Standard radiographs were obtained preoperatively and postoperatively. The pattern of lateral collateral ligament avulsion and its distribution were inferred from intraoperative records. RESULTS:Preoperative radiographs of the 131 patients showed 101 nonseparated fractures (77%, group I) and 30 unstable fractures (23%). Anterior displacement of the fragment was found in 18 elbows (14%, group II) and posterior displacement in 12 (9%, group III). LUCL avulsion was found in 18 of 30 unstable RHFs (60%) and in 1 of 60 stable RHFs (1.6%). CONCLUSION:RHF is a complex fracture often associated with soft tissue lesions. It is important to determine which structures need to be repaired to avoid complications that could lead to elbow instability. The RHF pattern and classification as stable or unstable can help the surgeon in the identification and treatment of LUCL lesions.

摘要

背景: 本研究的目的是确定尺骨外侧副韧带 (LUCL) 损伤与孤立性桡骨头骨折 (RHF) 相关。以及在无任何肱骨干脱位史的个体中,不稳定移位部分关节RHF中韧带损伤与碎片移位-失去接触的关系。 方法: 我们回顾性地确定了在我们机构进行的 131 例连续患者,他们接受了孤立的闭合性Mason II型RHF的切开复位和内固定。我们通过RHF的模式和不稳定片段 (前部或后部) 相对于肱骨小头的位置确定了 3 个亚群: 移位稳定 (I组),移位的前部不稳定 (ⅱ 组) 和移位的后部不稳定 (ⅲ 组)。术前和术后获得标准x光片。从术中记录推断外侧副韧带撕脱的模式及其分布。 结果: 131 例患者术前x线片显示 101 例未分离骨折 (77%,ⅰ 组) 和 30 例不稳定骨折 (23%)。碎片前移位 18 个肘部 (14%,ⅱ 组),后移位 12 个 (9%,ⅲ 组)。LUCL撕脱发现 1 8 30 不稳定RHFs (60%) 和 1 60 稳定RHFs (1.6%). 结论: RHF是一种复杂的骨折,常合并软组织病变。重要的是确定哪些结构需要修复,以避免可能导致肘关节不稳定的并发症。RHF模式和分类为稳定或不稳定,可以帮助外科医生识别和治疗LUCL病变。

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发表时间:2020-01-01
DOI:10.1002/acr.23824
作者列表:["Chen SK","Liao KP","Liu J","Kim SC"]

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发表时间:2020-01-01
DOI:10.1002/acr.23827
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