摘要
目的总结彻底剥离肱骨内外髁附着肌群-韧带复合体的肘关节松解术对创伤后肘关节僵硬的治疗效果。方法2003年3月-2007年12月,采用肱骨内外髁附着肌群-韧带复合体彻底剥离肘关节松解术治疗33例创伤后肘关节僵硬患者。男23例,女10例;年龄17～70岁,平均41.8岁。均经保守治疗失败,主观要求行进一步治疗。术前肘关节僵硬情况根据Morrey分类,非常严重(活动范围<30°)15例,严重(活动范围30～60°)18例。肘关节主动屈伸活动度为(32.5±28.9)°;按照Mayo肘关节功能指数评分标准评分为(51.9±13.1)分。检查及X线片证实患者骨折已骨性愈合。受伤至肘关节松解术时间2个月～6年,平均16.9个月。结果32例术后切口Ⅰ期愈合;1例发生切口感染,经局部换药及抗感染治疗后愈合。未发生术后关节不稳、明显疼痛等并发症。33例均获随访,随访时间6个月～5年,平均3.3年。末次随访时Mayo肘关节功能指数评分为(82.3±14.4)分,患肘主动屈伸活动度为(108.8±36.0)°,与术前比较差异有统计学意义(P<0.05);获优11例,良18例,中2例,差2例,优良率87.88%。31例患者均对术后结果感到满意或基本满意;2例患者对手术结果不满意,经再次手术松解后获较满意效果。结论彻底肘关节松解和术后康复锻炼有助于创伤后肘关节僵硬关节活动功能的恢复,同时确保了关节的侧方稳定性。
Objective To evaluate the results of open arthrolysis by elevated the lateral and medial collateral ligament-musculature complex from the supracondylar ridge of the humerus in treatment of post-traumatic elbow stiffness. Methods From March 2003 to December 2007, 33 patients with post-traumatic elbow stiffness were treated with open arthrolysis by elevated the lateral and medial collateral ligament-musculature complex from the supracondylar ridge of the humerus. There were 23 males and 10 females, aged 17-70 years old （mean 41.8 years old）. According to Morrey, 15 cases were extremely serious （less than 30° extension-flexion arc） and 18 cases were serious （30-60° extension-flexion arc）. The range of motion of the elbow stiffness was （32.5 ± 28.9）° and the Mayo score was 51.9±13.1 before operation. All initial fractures were healed according to clinical examination and X-rays films. All patients present with a post-traumatic elbow stiffness and the average period from initial trauma to elbow arthrolysis was 16.9 months （2-72 months）. Results Wound infection occurred in 1 patient and cured after dressing change and anti-infectious treatment. The wounds healed by first intension in 32 cases. No patient showed sign of elbow instability and debilitating pain. All patients were followed up 6 months to 5 years （mean 3.3 years）. At last follow up, the Mayo score was 82.3 ±14.4 and the range of motion of elbow stiffness was （108.8 ± 36.0）°; showing significant differences when compared with preoperation （P 〈 0.05）. According to Mayo evaluation, the results were excellent in 11 cases, good in 18 cases, fair in 2 cases, and poor in 2 cases, the excellent and good rate was 87.88%. Thirty-one patients achieve satisfactory results. Two patients were not satisfied with the result, but the satisfactory results were achieved by a second arthrolysis. Condusion Open elbow arthrolysis and postoperative rehabilitation for patients with elbow stiffness can improve joint function and ensure the
出处
《中国修复重建外科杂志》
CAS
CSCD
北大核心
2009年第9期1087-1091,共5页
Chinese Journal of Reparative and Reconstructive Surgery
关键词
肘关节僵硬
创伤
关节松解术
功能重建
Elbow stiffness Trauma Arthrolysis Function reconstruction
