Tulgar TOROS, Kemal ÖZAKSAR, Tahir Sadık SÜGÜN, Murat KAYALAR, Emin BAL, Sait ADA

Dirsek kötü üçleme yaralanmasında medial taraf onarımının sonuçlara etkisi

Amaç: Bu çalışmanın amacı dirsek kötü üçleme yaralanmalı olgularda medial kollateral ligamanın cerrahi onarımı ve ulnar sinirin gevşetilmesinin etkilerini değerlendirmekti. Çalışma planı: 1996-2007 yılları arasında, dirsekte kötü üçleme tanısıyla ameliyat edilen 16 hasta (ortalama yaş: 34) çalışmaya alındı. Hastaların ortalama takip süresi 34.5 ay idi. Tüm hastalarda radius başı tespiti/protezi, ön kapsül/koronoid bileşkesi onarımı, lateral kollateral ligaman onarımı yapıldıktan sonra; dirsek mediali 8 hastada onarıldı (medial kollateral ligaman onarımı ve ulnar sinir gevşetmesi), kalan 8 hastada ise onarılmadı. Hareket açıklığı, ağrı, stabilite, ulnar sinir belirtileri, fonksiyonel Mayo dirsek performansı indeksi ve Kol, Omuz ve El Sorunları (DASH) skorları değerlendirildi. Ulnohumeral artroz ve ektopik kalsifikasyonlar grafilerle değerlendirildi, ulnar sinir sıkışma MRG ve ultrasonografi bulguları ile tespit edildi. Bulgular: Medial onarım uygulanmayan hastalarda hareket açıklığı nispeten azdı. Ulnohumeral hareket ve fleksiyon dereceleri her iki grup arasında medial onarım yapılan grup lehine istatistiksel olarak anlamlı bulundu (p

The effect of medial side repair in terrible triad injury of the elbow

Objective: The aim of this study was to evaluate the effect of surgical repair of the medial collateral ligament and ulnar nerve release in cases of terrible triad injuries of the elbow. Methods: This study included 16 patients (average age: 34 years) who underwent surgery following a diagnosis of terrible triad injury of the elbow between 1996 and 2007. Average follow up was 34.5 months. In all cases, the radial head was first fixed or replaced and the anterior capsule/coronoid complex and lateral collateral ligament were repaired. The medial side of the elbow was addressed (medial collateral ligament repair and ulnar nerve release) in 8 cases and not addressed in the remaining 8 cases. Range of motion, pain, stability, ulnar nerve symptoms, functional Mayo Elbow Performance Index, and Disabilities of the Arm, Shoulder and Hand scores were documented. Serial X-rays were used to confirm ulnohumeral arthritis and development of ectopic calcification. Ultrasonography or MRI was used to detect ulnar nerve entrapment. Results: Range of motion was slightly more limited in cases where the medial side was not addressed. Ulnohumeral range of motion and flexion degrees were higher in the cases where the medial side was addressed (p

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