摘要
[目的]评价关节镜技术在肘关节剥脱性软骨炎诊断、治疗中的作用以及疗效。[方法]2011年5月~2014年7月,对17例患者施行肘关节镜检查、滑膜清理、游离体取出以及微骨折术,男11例,女6例;年龄15~35岁,左侧5例,右侧12例。17例均有肘关节疼痛,10例有肘关节卡压或绞锁等机械症状。患者取侧卧位全身麻醉下,经中外侧(软点)、近端前外侧、近端前内侧、后正中、后外侧等入路,行肘关节探查、清理、游离体取出以及微骨折术。分别测量术前术后肘关节伸直角度、屈曲角度、肘关节活动度,应用Mayo肘关节功能评分(Mayo elbow performance score,MEPS)评价疗效。[结果]术后患者伤口均I期愈合,无血管损伤并发症,17例获得10~48个月,平均28.5个月随访。术后15例(88.2%)肘疼痛消失或仅有轻微疼痛,2例(11.8%)肘仍有中等程度疼痛。10例有机械交锁症状者均消失。肘关节伸直角度、屈曲角度、肘关节活动度以及MEPS值均较术前明显改善(P<0.05),术后MEPS结果优11例,良3例,中2例,优良率:88.2%。术后并发症:1例尺神经暂时性麻痹。[结论]肘关节镜治疗肘关节剥脱性软骨炎疗效确切,可以明显缓解肘关节疼痛,改善关节活动范围,损伤小、恢复快。
[Objective] To investigate the role and outcomes of arthroscopic technique in the diagnosis and treatment of elbow osteochondritis dissecans. [Methods] A total of 17 patients were diagnozed as with elbow osteochondritis dissecans from May 2011 to July 2014. There were 11 male patients and 6 female patients,aged 15 ~ 35 years. Five patients had lesions in the left elbow and 12 had lesions in the right elbow. All the patients experienced pain in the elbow,and 10 had the symptoms of elbow entrapment or locks. The patients took the lateral position and received general anesthesia,and elbow exploration,debridement,removal of loose bodies,and microfrature surgery were performed through mid- lateral( soft spot),proximal anterolateral,proximal anteromedial,posterior median,and posterior- lateral passages. The elbow straight angle,elbow flexion angle,and range of motion of elbow joint were measured before and after surgery,and the Mayo elbow performance score( MEPS) was used to evaluate therapeutic effect. [Results] The patients were followed up for 10 ~ 48 months( mean 28. 5 months). After surgery,all the patients achieved stage I wound healing and no patients experienced the complication of vascular injury. Fifteen patients( 88. 2%) experienced disappearance of pain or mild pain,and 2( 11. 8%) experienced moderate pain. The mechanical symptom of locks disappeared in all 10 patients. The elbow straight angle,elbow flexion angle,range of motion of elbow joint,and MEPS were significantly improved after surgery( P < 0. 05). The results of postoperative MEPS showed that 11 patients achieved excellent improvement,3 achieved good improvement,and 2 achieved moderate improvement,and the excellent and good results rate was 88. 2%. As for postoperative complications,1 patient experienced temporal paralysis of the ulnar nerve. [Conclusion] Elbow arthroscopy is effective in the treatment of elbow osteochondritis dissecans and can significantly relieve elbow pain and improve the range of motion of elbow joint,with minor injury and fa
出处
《中国矫形外科杂志》
CAS
CSCD
北大核心
2016年第21期1959-1963,共5页
Orthopedic Journal of China
关键词
剥脱性骨软骨炎
肘关节
关节镜
微骨折
osteochondritis dissecans
elbow joint
arthroscopy
microfracture
