Gradual stability evaluation and repairment of the elbow joint fracture-dislocation

ZHANG Quan; CHEN Wen-jun; WANG Shi-long; TANG Chao-liang; ZHANG Bing-wen

doi:10.3969/j.issn.2095-252X.2016.04.003

Abstract：Objective To discuss the signiifcance of evaluating the gradual stability of the elbow joint with fracture-dislocation and repairing the bone and soft tissue structure step by step.Methods A total of 41 patients with elbow fracture-dislocation, treated in our hospital from April 2005 to March 2012, were studied retrospectively. Before the operation, the bone structure was evaluated according to the iconography to determine which type of injury was the main factor causing the instability and the operation plan was made. During the operation, the stress test was performed to evaluate the capsular ligament injury when the fracture was treated. The elbow stability was evaluated again after the operation to make sure whether it needed an assistant instrument and when to perform the function training.Results All 41 patients were evaluated before the operation according to the iconography. Ten cases were of complicated Monteggia fracture, 14 cases were terrible triad injury, 9 cases were transolecranon anterior dislocation, 4 cases were coronoid process fracture with dislocation, and 4 cases were radium head fracture with elbow dislocation. Thirty-four cases were found capsular ligament complex injury during the operation. Twenty-three cases were still instable after the bone structure was repaired and 18 cases among them got collateral ligament repaired. After the operation, 9 cases were instable and got assistant ifxation with brace, plaster or K-wire. The average follow-up time was 10.4 months. All fractures were healed. According to the JOA Evaluation Sheet, 12 cases were excellent, 19 cases were good, 7 cases were fair and 3 cases were poor.Conclusions Gradual evaluation of the stability of the elbow joint fracture-dislocation can help to ifnd factors causing instability and further get better function.