肘关节后外侧旋转不稳定的研究进展.pdfVIP

36 Chinese Journal of Reparative and Reconstructive Surgery, January 2012, Vol. 26, No.1 · · 肘关节后外侧旋转不稳定的研究进展 肖聪 黄富国 【摘 要】 目的 综述肘关节后外侧旋转不稳定（posterolateral rotatory instability ，PLRI ）的病理解剖、诊断及治 疗进展。 方法 查阅国内外有关肘关节PLRI 研究的相关文献，并进行综合分析。 结果 肘外侧韧带复合体（lateral collateral ligament complex，LCLC ）、桡骨头、肱骨小头及尺骨冠突损伤是导致肘关节PLRI 的重要因素，跨越肘外侧的肌 群起次要作用。临床检查主要包括侧方轴移试验、侧方轴移恐惧试验、撑椅征、俯卧撑试验、撑桌试验和后外侧旋转抽屉 试验。影像学、关节镜及超声检查可以协助诊断PLRI 。损伤的LCLC 可采用骨性固定重建或软组织固定重建方式。 结 论 LCLC 是PLRI 的首要限制结构。超声能准确识别并测量正常的LCLC ，有望成为一种可靠的无创检查方法。软组织 固定重建方式避免了医源性骨折的缺点，是一种可选择的治疗方法。 【关键词】 肘关节 后外侧旋转不稳定 研究进展 RESEARCH PROGRESS OF POSTEROLATERAL ROTATORY INSTABILITY OF THE ELBOW/XIAO Cong, HUANG Fuguo. Department of Orthopedics, West China Hospital, Sichuan University, Chengdu Sichuan, 610041, P.R.China. Corresponding author: HUANG Fuguo, E-mail: huang-f-g@163.com 【Abstract 】 Objective To review the progress in pathoanatomy, diagnosis, and treatment of posterolateral rotatory instabil ity (PLRI) of the elbow. Methods Related l iterature concerning PLRI of the elbow was extensively reviewed, comprehensive analysis was done. Results The lateral collateral l igament complex (LCLC), radial head, capitellum, and coronoid process are important constraints to PLRI. Muscle groups that cross the lateral elbow are secondary constraints to PLRI. Clinical examination includes lateral pivot-shift test, lateral pivot-shift apprehension test, chair sign, active floor push-up sign, tabletop relocation test, and posterolateral rotatory drawer test. Radiology, arthroscopy, and ultrasound can help diagnosis of PLRI. Reconstru