| 肘关节结核的手术治疗进展 |
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投稿时间：2019-05-12
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| 期刊信息：《中国骨伤》2019年，第32卷，第11期，第1072-1076页 |
| DOI：10.3969/j.issn.1003-0034.2019.11.019 |
| 基金项目:杭州市科技计划引导项目（编号：20181228Y16） |
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| 中文摘要:肘关节结核是一种较为少见的感染性骨关节病。手术治疗肘关节结核目的是保留关节功能，确保关节稳定性和提高生活质量，但对于不同术式的选择以及实施细节仍存在较大争议。对于晚期全肘关节结核，叉状成形术疗效确切，已能满足大部分无力量需求的患者，然而关节融合术仅推荐于有上肢力量需求的重体力劳动者，研究其最佳融合角度可提高患者满意度。对于早期全肘关节结核，关节间置成形术相关报道少，推荐度低；相反，铰链式外固定架联合关节松解术安全有效，感染复发率低，为主流术式，其关节松解术的最佳入路方式仍是目前研究热点。肘关节镜手术不仅可以镜下治疗肘关节单纯滑膜结核，而且镜下的活检术可提高阳性率，推荐早期应用于诊断不明的慢性肘关节肿痛。此外，全肘关节置换术未来可能是功能需求高的患者的一种选择。 |
| 【关键词】结核,骨关节 肘关节 综述 |
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| Progress on surgical treatment for elbow tuberculosis |
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| ABSTRACT Elbow tuberculosis is a rare disease of infectious osteoarthritis. The aim of operation for elbow tuberculosis is to maintain joint function,ensure stability of joint and improve quality of life,while there were controversies about the implementation details of different procedures. For elbow tuberculosis at an advanced stage,the clinical effect of forked osteotomy arthroplasty is effective and could meet with most patients without demand of strength. However,arthrodesis is only recommended for heavy manual workers with high demand of strength,and making research on the optimal fusion angle could improve satisfaction of patients. For elbow tuberculosis at the early stage,there were few reports about interposition arthroplasty,which has a recommendation of lower degree. Otherwise,hinged external fixator with arthrolysis is main procedure for its safety,effective clinical effects,and less recurrence of inflammation,the optimal approach of arthrolysis is the research focus at present. Elbow arthroscopic surgery could not only treat the simple synovial tuberculosis of elbow joint under arthroscope,but also improve positive rate under arthroscopic,and it is recommended to be used at the early unclear diagnosis of swelling and pain of chronic elbow joint. In addition,total elbow arthroplasty may be an option for patients with high functional requirements in the future. |
| KEY WORDS Tuberculosis,osteoarticular Elbow joint Review |
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| 引用本文，请按以下格式著录参考文献： |
| 中文格式: | 胡飞剑,李桥,毕大卫,祖罡.肘关节结核的手术治疗进展[J].中国骨伤,2019,32(11):1072~1076 |
| 英文格式: | HU Fei-jian,LI Qiao,BI Da-wei,ZU Gang.Progress on surgical treatment for elbow tuberculosis[J].zhongguo gu shang / China J Orthop Trauma ,2019,32(11):1072~1076 |
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