摘要
目的探讨创伤后肘关节僵硬的手术方式及其疗效。方法33例创伤后肘关节僵硬患者，其中男28例，女5例；年龄14～56岁，平均32岁。左17例，右16例。平均术前时间12个月。采用内、外侧双切口行关节囊切除及关节清理术，松解术前关节间隙变小及术后不稳定患者加用外固定架，外固定架于8周后去除。术后3d开始功能锻炼。平均随访时间为33个月。术前术后采用Mayo评分法进行评分。结果肘关节活动度由术前平均21°提高至术后的90°（P〈0．05），Mayo评分由术前平均54．24分增至术后84．24分（P〈0．05）。术前时间12个月以上及12个月以下者肘关节活动度改善差异无统计学意义。结论对于创伤后肘关节僵硬，术前细致评估，采用双侧切口行关节囊切除、关节清理，合理使用外固定架，术后指导患者功能锻炼，可以取得较好效果。
Objective To discuss the surgical treatment procedure for post-traumatic stiff elbow and the therapeutic results. Methods There were 33 cases at age of 14-56 years （ mean 32 years） with post-traumatic stiff elbow （28 males and 5 females）. The mean interval from initial injury to surgery was 12 months. We used both medial and lateral approaches to the elbow for capsulotomy and debridement. For cases with a narrow joint space and instability after release, we used hinged external fixators, which were removed after 8 weeks. The average follow-up was 33 months. We used Mayo elbow performance score for evaluation before and after operation. Results The mean range of motion was improved from preoperative 21° to postoperative 90°. The Mayo elbow performance score improved from 54.24 to 84.24 （ P 〈 0.05 ）. As for the interval from initial injury to surgery, there was no significant difference between the interval shorter than 12 months and that longer than 12 months. Conclusion For post-traumatic stiff elbow, careful preoperative evaluation, both medial and lateral approaches for capsulotomy and debridement, proper use of hinged external fixators and effective postoperative exercise can obtain good results.
出处
《中华创伤杂志》
CAS
CSCD
北大核心
2007年第5期344-347,共4页
Chinese Journal of Trauma
关键词
肘关节
创伤和损伤
功能恢复
手术
外科
Elbow joints
Wounds and injuries
Function recovery
Surgery, operative
