| 摘要: |
| 目的评估肘关节恐怖三联征损伤患者手术治疗后的功能结果和并发症。方法在Medline、EMBASE、CochraneLibrary和GoogleScholar等数据库检索关于肘关节恐怖三联征损伤的前瞻性、回顾性研究，并分析各项研究的患者术后功能结果和并发症。结果最终纳入16项研究，共312例患者。术后随访25~30个月，Mayo肘关节功能评分78~95分，Broberg-Morrey评分76~90分，肩臂手功能缺陷（DASH）评分9~31分。需再手术的并发症发生率范围0.0%~54.5%，总发生率为22.4%（70/312）；需再手术的并发症主要与内固定问题、关节僵硬、关节不稳、尺神经麻痹等相关。无需再手术的并发症主要是异位骨化（12.5%，39/312）和关节炎（11.2%，35/312）。结论肘关节恐怖三联征损伤术后功能结果令人满意，并发症较为常见，建议进一步规范手术技术以获得最佳功能结果，减少并发症。 |
| 关键词: 并发症 功能结果 肘关节恐怖三联征损伤 |
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| 基金项目:浙江省医药卫生科技计划项目（2014KYB296）；浙江省公益性技术应用研究项目（2013C33216）；义乌市科技攻关项目（2013-G3-02） |
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| Functional outcomes and complications following surgical management of terrible triad injury of the elbow：a meta-analysis |
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CHEN Hongwei, WANG Ziyang, LI Jun
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Yiwu Central Hospital
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| Abstract: |
| Objective To review the functional outcomes and complications following surgical management of terrible triad injury of the elbow (TTIE). Methods Medline, EMBASE, Cochrane Library, and Google Scholar were searched for retrospective or prospective clinical studies of TTIE with functional outcomes and complications following surgical management. Results Sixteen studies, involving 312 patients, were included in the systematic review. Mean follow up after surgery was 25 to 30 months. Mean Mayo elbow performance scores ranged from 78 to 95. Mean Broberg-Morrey scores ranged from 76 to 90. Mean DASH scores ranged from 9 to 31. The proportion of patients who required reoperation due to complications ranged from 0.0% to 54.5%(mean: 22.4%). Most of these complications were related to hardware fixation problems, joint stiffness, joint instability, and ulnar neuropathy. The most common complications not requiring reoperation were heterotopic ossification (12.5%, 39 patients) and arthrosis (11.2% , 35 patients). Conclusion The results of this systematic review indicate that functional outcomes after surgery for TTIE are generally satisfactory and that complications are common. Further studies are warranted to determine the surgical modalities which can optimize functional outcomes and reduce the risk of complications. |
| Key words: Complication Functional outcome Terrible triad injury of the elbow |
