CAJ | 학술논문

目的探讨Coonrad-Morrey型半限制型假体全肘关节置换术的疗效.方法 2003年12月至2008年4月采用Coonrad-Morrey半限制型假体治疗肘部疾患30例(31肘),其中新鲜肱骨髁间骨折18例,髁间骨折内固定失效或骨折不愈合9例,类风湿性肘关节炎(RA)2例(3肘),骨性关节炎(OA)1例;其中男性8例,女性22例;年龄47～78岁,平均66岁.结果 20例(21肘)获得随访,均为骨折患者,平均随访35个月(12～52个月),术前因疼痛无法判断Mayo肘关节功能评分(MEPS评分),术后MEPS评分平均为84分;21肘中,6肘优(28%),11肘良(52%),2肘可(10%),2肘差(10%).优良率80%.并发症:1例术后发生"针-针系统"失效,1例术后切口迟延愈合,1例尺神经支配区域感觉减退,2例异位骨化.结论全肘关节置换治疗肘关节损伤可解除疼痛、恢复稳定性及改善活动范围.对于老年肱骨髁间粉碎性骨折及骨折不愈合,严格选择病例,可获得较满意疗效.
목적 탐토Coonrad-Morrey형반한제형가체전주관절치환술적료효.방법 2003년12월지2008년4월채용Coonrad-Morrey반한제형가체치료주부질환30례(31주),기중신선굉골과간골절18례,과간골절내고정실효혹골절불유합9례,류풍습성주관절염(RA)2례(3주),골성관절염(OA)1례;기중남성8례,녀성22례;년령47～78세,평균66세.결과 20례(21주)획득수방,균위골절환자,평균수방35개월(12～52개월),술전인동통무법판단Mayo주관절공능평분(MEPS평분),술후MEPS평분평균위84분;21주중,6주우(28%),11주량(52%),2주가(10%),2주차(10%).우량솔80%.병발증:1례술후발생"침-침계통"실효,1례술후절구지연유합,1례척신경지배구역감각감퇴,2례이위골화.결론 전주관절치환치료주관절손상가해제동통、회복은정성급개선활동범위.대우노년굉골과간분쇄성골절급골절불유합,엄격선택병례,가획득교만의료효.
Objective To retrospectively review the results of Coonrad-Morrey semi-constrained total elbow arthroplasty (TEA) for the treatment of different elbow disorders. Methods Between December 2003 and April 2008, 30 patients with different kinds of elbow disorders including elbow fracture, nonhealing elbow fracture, theumatoid arthritis and osteoarthritis were treated with TEA using the serruconstrained Coonrad-Morrey elbow replacement prosthese8. One patient had bilateral total elbow replacements. There were 22 females and 8 males, with a mean age of 66 years (47 to 78). Results Twenty patients (21 elbows) were available for review. The average lengtb of follow-up was 35 months (from 12 to 52 months). The mean Mayo elbow performance score was 84 points. Excellent results were achieved in 6 elbows (28%), 11 elbows had good outcome (52%), 2 elbows had improvement (10%), while the other 2 elbows had no improvement (10%). The 2 elbows with distal humeral fractures, had no pain after treatment but developed heterotopic ossification, which caused stiffness and lower the Mayo elbow performance score. One delayed healing of the wound, one patient experienced temporary radial nerve hypesthesia and one elbow showed transparent region around the implant without radiological sign of loosening in the implanted prostheses. Conclusions This study reveals good to excellent outcome with the use of semi-constrained TEA for the treatment of theumatoid arthntis, elbow fracture, osteoarthritis and non-healing elbow fractures in elder patients. The non-healing elbow fractures in elder patients would accompany with severe osteoporosis and comminuted fracture, which would affect the result of open reduction internal fixation. So TEA may be one optimal treatment for these pallents.