肘关节内侧副韧带重建术用于修复肘关节韧带撕裂。这种损伤通常由于胳膊强烈的、反复的过顶的投掷动作或肘关节脱位引起。因为美国外科医生乔布(Frank Jobe)在1974年为棒球投手汤米约翰(Tommy John)施行了本手术,故名Tommy John手术。
乔布出生于1925年,18岁加入美军,曾是二次大战的医官之一,战争结束之后回到洛杉矶发展,1965年分别担任大联盟道奇队、NBA湖人队与NFL公羊队(现圣路易公羊)队医。他与尤康(Lewis Yocum)及安德鲁斯(James Andrews),在大联盟并称三大名医。2014年3月去世,享年88岁。
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Overview(概述)
This procedure is designed to repair a torn elbow ligament - an injury typically caused by strong, repetitive overhead throwing motions of the arm or by dislocation of the elbow. It was first performed in 1974 on baseball pitcher Tommy John.
本手术被设计用于修复肘关节韧带撕裂,这种损伤通常由于胳膊强烈的、反复的过顶的投掷动作或肘关节脱位引起。因为在1974年为棒球投手Tommy John施行了本手术,故名Tommy John手术。
Preparation(准备)
The surgeon harvests a tendon from the patient's own body. The palmaris longus tendon of the forearm is most frequently used, but the surgeon may instead choose to take a tendon from the hand, wrist or knee. In some cases, a tendon from an organ donor may be used.
外科医生需要从患者自己身上切取肌腱。前臂的掌长肌腱是经常使用的移植材料,但外科医生也可能会选取手部、腕部或膝部的肌腱。在有些病例,可能会使用器官捐献者身上的肌腱。
Accessing the Elbow Joint(显露肘关节)
The surgeon makes an incision along the inner side of the elbow, exposing the damaged medial ulnar collateral ligament.
外科医生在沿肘关节内侧作一切口,显露受伤的内侧尺侧副韧带。
Drilling the Holes(钻孔)
Tunnels are drilled through the humerus (upper arm bone) and ulna (a lower arm bone) at the points where the damaged ligament normally attaches.
在肱骨(上臂骨)和尺骨(前臂骨之一)上,受伤的韧带正常附着于骨的部位钻孔。
Inserting the Tendon(插入韧带)
The harvested tendon is looped through the tunnels in a figure-eight pattern. The tendon is sutured to itself, stabilizing the joint.
将获得的肌腱以“8”字形穿过骨隧道并连成环。肌腱自相吻合,将关节稳定起来。
End of Procedure(手术结束)
The incision is closed, and the elbow is immobilized in a hard brace for one to two weeks. The patient may then be allowed to switch to a hinged brace and begin limited exercise of the arm. Supervised throwing may begin at three to four months; competitive throwing may be allowed at six to nine months. Most athletes regain their pre-injury level of function about 12-18 months after surgery.
逐层关节切口。术后1~2周内将肘关节用硬支具固定制动。然后换用绞链式支具开始进行胳膊的有限活动。3-4月后在医生或康复师指导下进行投掷运动。6~9月后可以参加投掷比赛。许多运动员在术后12~18月恢复到受伤前的水平。
(胡佰文 译)
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