【摘要】 [目的]探讨内侧副韧带（medial collateral ligament, MCL）、桡骨小头（radial head, RH）对肘外翻稳定性的影响，评价单独或联合修复MCL、固定RH骨折的效果。[方法] 6具成人新鲜尸体肘关节骨-韧带标本，依次给予：完整肘关节，MCL切断，MCL修复，MCL切断+RH骨折，MCL修复+RH骨折，MCL切断+RH固定，MCL修复+RH固定和MCL修复+RH切除8种处理，在0°～120°屈肘位施加1.5 N·m的外翻载荷下测量外翻角位移。[结果]在屈肘0°位标本8种处理状态下外翻角位移由小至大：完整标本<MCL修复+RH固定<MCL修复<MCL修复+RH骨折<MCL修复+RH切除<MCL切断<MCL切断+RH固定<MCL切断+RH骨折，整体差异有统计学意义（P<0.05）。两两比较，完整标本、MCL修复、MCL修复+RH固定、MCL修复+RH骨折和MCL修复+RH切除间外翻角位移的差异无统计学意义（P>0.05），但以上5组的外翻角位移均显著小于MCL切断、MCL切断+RH固定、MCL切断+RH骨折组（P<0.05）。资料的重复测量方差分析表明，8种标本处理状态间外翻角位移的差异有统计学意义（F组间=227.670,P<0.001）,5种不同屈肘角度间外翻角位移的差异有统计学意义（F屈角=13.170,P<0.001），标本处理状态与屈肘角度间存在显著交互作用（F交互=6.143,P<0.001）。[结论] MCL损伤即可引起肘外翻不稳定，合并RH骨折，则导致严重外翻不稳定。单独修复MCL优于单独固定RH骨折，足以恢复外翻稳定性。更多还原

【Abstract】 [Objective] To explore the role of medial collateral ligament(MCL) and radial head(RH) on elbow valgus stability, and to evaluate the outcomes of MCL repair and RH fracture fixation alone or in combination. [Methods] Six adult cadaveric bone-ligament specimens were treated and measured successively as follows: intact specimens, MCL cutting, MCL repair, MCL cutting +RH fracture, MCL repair +RH fracture, MCL cutting +RH fixation, MCL repair +RH fixation and MCL repair +RH resection. The valgus angular displacement(VAD) was measured under 1.5 N · m valgus loading at 0°～120° flexions of the elbow. [Results] The VAD at 0° of elbow flexion ranked down-up as follows: intact specimen < MCL repair +RH fixation < MCL repair < MCL repair +RH fracture < MCL repair +RH resection <MCL cutting < MCL cutting +RH fixation < MCL cutting +RH fracture, with statistically significant overall difference(P<0.05). In term of pairwise comparison, there was no significant difference in VAD between intact specimens, MCL repair, MCL repair +RH fixation, MCL repair +RH fracture, MCL repair +RH resection(P>0.05), but the above 5 groups had significantly less VAD than MCL cutting, MCL cutting +RH fixation and MCL cutting +RH fracture group(P<0.05). As results of factorial design analysis of variance, there were statistically significant differences in VAD among the 8 specimen treatments(Ftreat= 227.670, P<0.01), statistically significant differences in VAD among 5 degrees of elbow flexions(Fflexion= 13.170, P<0.01), and significant interaction between specimen treatments and flexions of the elbow(Finter=6.143, P<0.01). [Conclusion] MCL injury does lead to elbow valgus instability, which is considerably deteriorated by accompanied RH fracture. MCL repair alone is superior to RH fracture fixation alone to restore valgus stability.更多还原