Лечение простой травматической нестабильности локтевого сустава

Лечение простой травматической нестабильности локтевого сустава

Автор: Егиазарян К.А., Ратьев А.П., Данилов М.А., Бадриев Д.А.

Журнал: Кафедра травматологии и ортопедии @jkto

Рубрика: Обзор литературы

Статья в выпуске: 4 (46), 2021 года.

Бесплатный доступ

В данной работе выполнен анализ данных опубликованных в мировой литературе по лечению острой простой травматической нестабильности локтевого сустава и простых вывихов костей предплечья, предоставлены данные эпидемиологии, обозначены анатомические особенности статических и динамических стабилизаторов локтевого сустава, подробно разобраны изученные на настоящее время возможные механизмы травмы, приведены современные классификации вывихов костей предплечья и нестабильности локтевого сустава, которые достаточно сложны для применения в клинической практике из-за своей громоздкости, связанной с большим количеством мягкотканых структур, повреждающих при вывихе, с необходимостью учитывать временной фактор и направление вывиха. Также продемонстрирован подробный перечень диагностических мероприятий, выполняемых до и после устранения вывиха костей предплечья. На примере ряда исследований изучены современные тенденции консервативного лечения простых вывихов предплечья, заключающиеся в снижение сроков иммобилизации локтевого сустава и даже отказе от постоянной иммобилизации, ранней разработке движений, которая благоприятно сказывается на амплитуде движений и не способствует развитию нестабильности. Основным критерием, определяющим необходимость оперативного лечения после устранения вывиха костей предплечья, является сохраняющаяся нестабильность локтевого сустава. Произведена попытка на основании данных отечественных и зарубежных публикаций обнаружить предикторы нестабильности локтевого сустава и определить исчерпывающие критерии, при которых необходимо выполнять реконструкцию связок локтевого сустава.

Еще

Вывих костей предплечья, острая травматическая нестабильность локтевого сустава

Короткий адрес: https://sciup.org/142234534

IDR: 142234534

Список литературы Лечение простой травматической нестабильности локтевого сустава

  • De Haan J. et al. Simple elbow dislocations: A systematic review of the literature // Arch. Orthop. Trauma Surg. 2010. Vol. 130, № 2. P. 241–249.
  • Hackl M. et al. Reliability of magnetic resonance imaging signs of posterolateral rotatory instability of the elbow // J. Hand Surg. Am. Elsevier Inc, 2015. Vol. 40, № 7. P. 1428–1433.
  • Cho C.-H. et al. Common Extensor Complex Is a Predictor to Determine the Stability in Simple Posterolateral Elbow Dislocation: Analysis of MR Images of Stable vs. Unstable Dislocation // J. Clin. Med. 2020. Vol. 9, № 10. P. 3094.
  • Coonrad R.W. et al. The drop sign, a radiographic warning sign of elbow instability // J. Shoulder Elb. Surg. 2005. Vol. 14, № 3. P. 312–317.
  • Maripuri S.N. et al. Simple elbow dislocation among adults: A comparative study of two different methods of treatment // Injury. 2007. Vol. 38, № 11. P. 1254–1258.
  • Mayne I.P. et al. The epidemiology of closed reduction for simple elbow dislocations and the incidence of early subsequent open reduction // J. Shoulder Elb. Surg. Elsevier Ltd, 2015. Vol. 24, № 1. P. 83–90.
  • Stoneback J.W. et al. Incidence of elbow dislocations in the United States population // J. Bone Jt. Surg. - Ser. A. 2012. Vol. 94, № 3. P. 240–245.
  • Anakwe R.E. et al. Patient-reported outcomes after simple dislocation of the elbow // J. Bone Jt. Surg. - Ser. A. 2011. Vol. 93, № 13. P. 1220–1226.
  • Bo E. Per Olof Josefsson Bo E, Nilsson. 1986. Vol. 30. P. 537–538.
  • Heo Y.M. et al. Unstable simple elbow dislocation treated with the repair of lateral collateral ligament complex // CiOS Clin. Orthop. Surg. 2015. Vol. 7, № 2. P. 241–247.
  • Sheps D.M., Hildebrand K.A., Boorman R.S. Simple dislocations of the elbow: Evaluation and treatment // Hand Clin. 2004. Vol. 20, № 4. P. 389–404.
  • Calderazzi F. et al. Simple and stable elbow dislocations: Results after conservative treatment // Acta Biomed. 2020. Vol. 91. P. 224–231.
  • Josefsson P.O., Johnell O., Wendeberg B. Ligamentous injuries in dislocations of the elbow joint // Clinical Orthopaedics and Related Research. 1987. Vol. No. 221. P. 221–225.
  • Josefsson P.O., Johnell O., Gentz C.F. Long-term sequelae of simple dislocation of the elbow // J. Bone Jt. Surg. - Ser. A. 1984. Vol. 66, № 6. P. 927–930.
  • Бабовников А.В., Гнетецкий С.Ф., Пряжников Д.А. Оперативное лечение переломов костей, образующих локтевой сустав //Хи- рург. 2008. №. 3. С. 73-74.[Babovnikov A. V., Gneteckij S. F., Prjazhnikov D. A. Surgical treatment of fractures of the bones forming the elbow joint. Hirurg. 2008. №. 3. P. 73-74. (in Russ.)]
  • Adams J.E. Elbow Instability: Evaluation and Treatment // Hand Clin. Elsevier Inc, 2020. Vol. 36, № 4. P. 485–494.
  • Rezaie N. et al. Elbow Dislocation // Clin. Sports Med. Elsevier Inc, 2020. Vol. 39, № 3. P. 637–655.
  • Ратьев А. П. Лечение повреждений области локтевого сустава: дис. – Первый моск. гос. мед. ун-т. им. ИМ Сеченова, 2015. Rat’ev A. P. Lechenie povrezhdenij oblasti loktevogo sustava.Dokt, Diss.[Treatment of injuries of the elbow joint].Moscow, 2015. 252 p. (in Russ.)
  • Modi C.S. et al. The frequency and risk factors for subsequent surgery after a simple elbow dislocation // Injury. Elsevier Ltd, 2015. Vol. 46, № 6. P. 1156–1160.
  • O’Driscoll S.W. et al. Difficult elbow fractures: pearls and pitfalls. // Instr. Course Lect. United States, 2003. Vol. 52. P. 113–134.
  • Journal T. of the Elbow * t. 1991.
  • Диагностика и лечение травматической нестабильности локтевого сустава : учеб. пособие / В.И. Зоря, А.В. Бабовников, М.В. Паршиков, С.Н. Хорошков, С.Ф. Гнетецкий, Е.И. Саввиди. М.: МГМСУ, 2012. 91 с. [Zorya V.I., Babovnikov A.V., Parshikov M.V., Horoshkov S.N., Gneteckij S.F., Savvidi E.I Diagnostika i lechenie travmaticheskoj nestabil’nosti loktevogo sustava [Diagnosis and treatment of traumatic instability of the elbow joint]. Moscow, MSMDU, 2012. 91 p.] (in Russ.)
  • Beingessner D.M. et al. The effect of coronoid fractures on elbow kinematics and stability // Clin. Biomech. 2007. Vol. 22, № 2. P. 183–190.
  • Morrey B.F., An K.N. Stability of the elbow: Osseous constraints // J. Shoulder Elb. Surg. 2005. Vol. 14, № 1 SUPPL. P. S174–S178.
  • Armstrong A. Simple Elbow Dislocation // Hand Clin. Elsevier Inc, 2015. Vol. 31, № 4. P. 521–531.
  • Dunning C.E. et al. Ligamentous stabilizers against posterolateral rotatory instability of the elbow // J. Bone Jt. Surg. - Ser. A. 2001. Vol. 83, № 12. P. 1823–1828.
  • Armstrong A.D. et al. Rehabilitation of the medial collateral ligament-deficient elbow: An in vitro biomechanical study // J. Hand Surg. Am. 2000. Vol. 25, № 6. P. 1051–1057.
  • Robinson P.M., Griffiths E., Watts A.C. Simple elbow dislocation // Shoulder Elb. 2017. Vol. 9, № 3. P. 195–204.
  • O’Driscoll S.W. et al. Elbow subluxation and dislocation: A spectrum of instability // Clinical Orthopaedics and Related Research. 1992. № 280. P. 186–197.
  • Hildebrand K.A., Patterson S.D., King G.J.W. Acute elbow dislocations: Simple and complex // Orthop. Clin. North Am. 1999. Vol. 30, № 1. P. 63–79.
  • O’Driscoll S.W. et al. The unstable elbow. // Instr. Course Lect. 2001. Vol. 50, № March 2001. P. 89–102.
  • Schwab G.H. et al. Biomechanics of elbow instability: the role of the medial collateral ligament. // Clin. Orthop. Relat. Res. United States, 1980. № 146. P. 42–52.
  • Ramirez M.A., Stein J.A., Murthi A.M. Varus Posteromedial Instability. // Hand Clin. United States, 2015. Vol. 31, № 4. P. 557–563.
  • Josefsson P.O. et al. Surgical versus non-surgical treatment of ligamentousinjuries following dislocation of the elbow joint. A prospective randomized study. // J. Bone Joint Surg. Am. United States, 1987. Vol. 69, № 4. P. 605–608.
  • Schreiber J.J. et al. Magnetic resonance imaging findings in acute elbow dislocation: insight into mechanism. // J. Hand Surg. Am. United States, 2014. Vol. 39, № 2. P. 199–205.
  • Modi C.S. et al. The frequency and risk factors for subsequent surgery after a simple elbow dislocation. // Injury. Netherlands, 2015. Vol. 46, № 6. P. 1156–1160.
  • O’Brien M.J., Lee Murphy R., Savoie F.H. 3rd. A preliminary report of acute and subacute arthroscopic repair of the radial ulnohumeral ligament after elbow dislocation in the high-demand patient. // Arthrosc. J. Arthrosc. Relat. Surg. Off. Publ. Arthrosc. Assoc. North Am. Int. Arthrosc. Assoc. United States, 2014. Vol. 30, № 6. P. 679–687.
  • Rhyou I.H., Kim Y.S. New mechanism of the posterior elbow dislocation. // Knee Surg. Sports Traumatol. Arthrosc. Germany, 2012. Vol. 20, № 12. P. 2535–2541.
  • Søjbjerg J.O., Helmig P., Kjaersgaard-Andersen P. Dislocation of the elbow: an experimental study of the ligamentous injuries. // Orthopedics. United States, 1989. Vol. 12, № 3. P. 461–463.
  • Linscheid R.L., Wheeler D.K. Elbow dislocations. // JAMA. UnitedStates, 1965. Vol. 194, № 11. P. 1171–1176.
  • Luokkala T. et al. Analysis of magnetic resonance imaging-confirmed soft tissue injury pattern in simple elbow dislocations. // J. shoulder Elb. Surg. United States, 2019. Vol. 28, № 2. P. 341–348.
  • Chung C.B., Stanley A.J., Gentili A. Magnetic resonance imaging of elbow instability. // Semin. Musculoskelet. Radiol. United States, 2005. Vol. 9, № 1. P. 67–76.
  • Morrey B.F. Acute and Chronic Instability of the Elbow. // J. Am. Acad. Orthop. Surg. United States, 1996. Vol. 4, № 3. P. 117–128.
  • Ring D., Jupiter J.B. Fracture-dislocation of the elbow. // J. BoneJoint Surg. Am. United States, 1998. Vol. 80, № 4. P. 566–580.
  • O’Driscoll S.W. Classification and evaluation of recurrent instability of the elbow. // Clin. Orthop. Relat. Res. United States, 2000. № 370. P. 34–43.
  • Rotini R. An overview about elbow instability. // Musculoskeletal surgery. Italy, 2014. Vol. 98 Suppl 1. P. 1–3.
  • Marinelli A., Guerra E., Rotini R. Elbow instability: Are we able to classify it? Review of the literature and proposal of an all-inclusive classification system. // Musculoskelet. Surg. Italy, 2016. Vol. 100, № Suppl 1. P. 61–71.
  • Pacelli L.L., Guzman M., Botte M.J. Elbow instability: the orthopedic approach. // Semin. Musculoskelet. Radiol. United States, 2005. Vol. 9, № 1. P. 56–66.
  • Goretti C. et al. Injury of the brachial artery accompanying simple closed elbow dislocation: a case report. // Acta Biomed. 2020. Vol. 91, № 14-S. P. e2020030.
  • Lutter C., Pfefferkorn R., Schoeffl V. Arterial damages in acute elbow dislocations: which diagnostic tests are required? // BMJ Case Rep. 2016. Vol. 2016.
  • Cohen M.S., Hastings H. 2nd. Acute elbow dislocation: evaluation and management. // J. Am. Acad. Orthop. Surg. United States, 1998. Vol. 6, № 1. P. 15–23.
  • Локтевой сустав : учеб. пособие / под ред. К.А. Егиазаряна, А.П. Ратьева. М.: Мед. информ. агентство, 2019. 464 с. [Egiazarjan K.A., Rat’ev A.P. Loktevoj sustav [Elbow joint]. Moscow, Med. inform. agentstvo,2019. 91 p.] (in Russ.)
  • Eygendaal D. et al. Posterolateral dislocation of the elbow joint. Relationship to medial instability. // J. Bone Joint Surg. Am. United States, 2000. Vol. 82, № 4. P. 555–560.
  • Duckworth A.D. et al. Residual subluxation of the elbow after dislocation or fracture-dislocation: treatment with active elbow exercises and avoidance of varus stress. // J. shoulder Elb. Surg. United States, 2008. Vol. 17, № 2. P. 276–280.
  • Rosas H.G., Lee K.S. Imaging acute trauma of the elbow. // Semin. Musculoskelet. Radiol. United States, 2010. Vol. 14, № 4. P. 394–411.
  • Feldman D.R. et al. Translational injuries in posterior elbow dislocation. // Skeletal Radiol. Germany, 1997. Vol. 26, № 2. P. 134–136.
  • Kaplan L.J., Potter H.G. MR imaging of ligament injuries to theelbow. // Radiol. Clin. North Am. United States, 2006. Vol. 44, № 4. P. 583594, ix.
  • Cates R.A., Steinmann S.P., Adams J.E. Irreducible anteromedial radial head dislocation caused by the brachialis tendon: a case report. // J. shoulder Elb. Surg. United States, 2016. Vol. 25, № 8. P. e232-5.
  • Tajika T. et al. The morphologic change of the ulnar collateral ligament of elbow in high school baseball pitchers, with and without symptoms, by sonography. // J. shoulder Elb. Surg. United States, 2016. Vol. 25, № 8. P. 1223–1228.
  • Konin G.P., Nazarian L.N., Walz D.M. US of the elbow: indications, technique, normal anatomy, and pathologic conditions. // Radiogr. a Rev.Publ. Radiol. Soc. North Am. Inc. United States, 2013. Vol. 33, № 4. P. E125-47.
  • Timmerman L.A., Andrews J.R. Undersurface tear of the ulnar collateral ligament in baseball players. A newly recognized lesion. // Am. J. Sports Med. United States, 1994. Vol. 22, № 1. P. 33–36.
  • McCabe M.P., Savoie F.H. 3rd. Simple elbow dislocations: evaluation, management, and outcomes. // Phys. Sportsmed. England, 2012. Vol. 40, № 1. P. 62–71.
  • Field L.D. et al. Arthroscopic assessment of the medial collateral ligament complex of the elbow. // Am. J. Sports Med. United States, 1995. Vol. 23, № 4. P. 396–400.
  • LAVINE L.S. A simple method of reducing dislocations of the elbow joint. // J. Bone Joint Surg. Am. United States, 1953. Vol. 35-A, № 3. P. 785–786.
  • PARVIN R.W. Closed reduction of common shoulder and elbow dislocations without anesthesia. // AMA. Arch. Surg. United States, 1957. Vol. 75, № 6. P. 972–975.
  • Schnetzke M. et al. Unstable simple elbow dislocations: mediumterm results after non-surgical and surgical treatment. // Knee Surg. Sports Traumatol. Arthrosc. Germany, 2017. Vol. 25, № 7. P. 2271–2279.
  • Ross G. et al. Treatment of simple elbow dislocation using an immediate motion protocol. // Am. J. Sports Med. United States, 1999. Vol. 27, № 3. P. 308–311.
  • Panteli M. et al. Cost analysis and outcomes of simple elbow dislocations. // World J. Orthop. 2015. Vol. 6, № 7. P. 513–520.
  • Iordens G.I.T. et al. Early mobilisation versus plaster immobilization of simple elbow dislocations: results of the FuncSiE multicentre randomized clinical trial. // Br. J. Sports Med. England, 2017. Vol. 51, № 6. P. 531–538.
  • Rafai M. et al. [Pure posterior luxation of the elbow in adults: immobilization or early mobilization. A randomized prospective study of 50 cases]. // Chir. Main. France, 1999. Vol. 18, № 4. P. 272–278.
  • Van Lieshout E.M.M. et al. Early mobilization versus plaster immobilization of simple elbow dislocations: a cost analysis of the FuncSiE multicenter randomized clinical trial. // Arch. Orthop. Trauma Surg. 2020. Vol. 140, № 7. P. 877–886.
  • Pogliacomi F. et al. Total elbow arthroplasty following traumas: mid-term results. // Acta Biomed. Italy, 2014. Vol. 84, № 3. P. 212–218.
  • Pogliacomi F. et al. Total elbow arthroplasty in distal humeral nonunion: clinical and radiographic evaluation after a minimum follow-up ofthree years. // J. shoulder Elb. Surg. United States, 2015. Vol. 24, № 12. P. 1998–2007.
  • Schreiber J.J. et al. Conservative management of elbow dislocations with an overhead motion protocol. // J. Hand Surg. Am. United States, 2015. Vol. 40, № 3. P. 515–519.
  • Cohen M.S. Lateral collateral ligament instability of the elbow. // Hand Clin. United States, 2008. Vol. 24, № 1. P. 69–77.
  • Wang W. et al. Stability of severely stiff elbows after complete open release: treatment by ligament repair with suture anchors and hinged external fixator. // J. shoulder Elb. Surg. United States, 2014. Vol. 23, № 10. P. 1537–1544.
  • Dos Santos A. et al. Cadaveric assessment of a 3D-printed aiming device for implantation of a hinged elbow external fixator. // Eur. J. Orthop. Surg. Traumatol. France, 2017. Vol. 27, № 3. P. 405–414.
  • Rhyou I.H. et al. Drop sign of the elbow joint after surgical stabilization of an unstable simple posterolateral dislocation: natural course and contributing factors. // J. shoulder Elb. Surg. United States, 2015. Vol. 24, № 7. P. 1081–1089.
  • Jones K.J. et al. The docking technique for lateral ulnar collateral ligament reconstruction: surgical technique and clinical outcomes. // J. shoulder Elb. Surg. United States, 2012. Vol. 21, № 3. P. 389–395.
  • King G.J.W. et al. Single-strand reconstruction of the lateral ulnar collateral ligament restores varus and posterolateral rotatory stability of the elbow. // J. shoulder Elb. Surg. United States, 2002. Vol. 11, № 1. P. 60–64.
  • Scheiderer B. et al. LUCL internal bracing restores posterolateral rotatory stability of the elbow. // Knee Surg. Sports Traumatol. Arthrosc. Germany, 2020. Vol. 28, № 4. P. 1195–1201.
  • Wilk K.E. et al. Repair of the Ulnar Collateral Ligament of the Elbow: Rehabilitation Following Internal Brace Surgery. // J. Orthop. Sports Phys. Ther. United States, 2019. Vol. 49, № 4. P. 253–261.
  • Clarke A.W. et al. Lateral elbow tendinopathy: correlation of ultrasound findings with pain and functional disability. // Am. J. Sports Med. United States, 2010. Vol. 38, № 6. P. 1209–1214.
  • Arirachakaran A. et al. Platelet-rich plasma versus autologous blood versus steroid injection in lateral epicondylitis: systematic review and network meta-analysis. // J. Orthop. Traumatol. Off. J. Ital. Soc. Orthop. Traumatol. 2016. Vol. 17, № 2. P. 101–112.
  • Jockel C.R., Katolik L.I., Zelouf D.S. Simple medial elbow dislocations: a rare injury at risk for early instability. // J. Hand Surg. Am. United States, 2013. Vol. 38, № 9. P. 1768–1773.
  • Boretto J.G. et al. Comparative study of simple and complex open elbow dislocations. // Clin. Orthop. Relat. Res. 2014. Vol. 472, № 7. P. 2037–2043.
  • Thomas L.G., Williams D.T. Simple posterior elbow dislocation and brachial artery transection. // J. R. Army Med. Corps. England, 2012. Vol. 158, № 1. P. 50–52.
  • Shukla D.R. et al. Heterotopic ossification formation after fracture- dislocations of the elbow. // J. shoulder Elb. Surg. United States, 2015. Vol. 24, № 3. P. 333–338.
  • Garland D.E. A clinical perspective on common forms of acquired heterotopic ossification. // Clin. Orthop. Relat. Res. United States, 1991. № 263. P. 13–29.
  • Balboni T.A., Gobezie R., Mamon H.J. Heterotopic ossification: Pathophysiology, clinical features, and the role of radiotherapy for prophylaxis. // Int. J. Radiat. Oncol. Biol. Phys. United States, 2006. Vol. 65, № 5. P. 1289–1299.
  • Лечение остеоартроза локтевого сустава / А.П. Ратьев, К.А. Егиазарян, Е.А. Жаворонков, В.С. Мельников // Вопросы рекоструктивной и пластической хирургии. 2014. № 2. С. 50-60. [Rat’ev A.P., Egiazaryan K.A., Zhavoronkov E.A., Mel’nikov V.S. Lechenie osteoartroza loktevogo sustava [Treatment of osteoarthritis of the elbow joint]. Voprosy rekonstruktivnoj i plasticheskoj hirurgii, 2014, no.17, pp. 50-60.] (In Russian)
  • Алгоритм лечения больных с переломами головки лучевой кости. / Е.А. Жаворонков, А.В. Скороглядов, Г.В. Коробушкин, А.П. Ратьев // Российский медицинский журнал. 2012. № 1. С. 22-23. [Zhavoronkov, E. A., Skoroglyadov, A. V., Korobushkin, G. V., Rat’ev, A. P. Algoritm lecheniya bol’nyh s perelomami golovki luchevoj kosti [Algorithm of treatment of patients with fractures of the head of the radius]. Rossijskij medicinskij zhurnal, 2012, no.1, pp. 22-23.] (In Russian)
  • Повреждение локтевого сустава: учеб. пособие / В.И. Зоря, А.В. Бабовников. М.: ГЭОТАР-Медиа, 2013. 464 с. [Zorya V.I., Babovnikov A.V. Povrezhdenie loktevogo sustava [Elbow joint injury]. Moscow, GEOTAR-Media, 2013. 464 p.] (In Russian)
Еще
Статья обзорная
SciUp 2024 © 2024 ©