摘要
目的探讨肘关节滑膜软骨瘤病的临床特点及关节镜术在该病诊断和治疗中的应用价值、操作要点及临床疗效。方法 1997年1月～2007年1月15例肘关节滑膜软骨瘤病患者行关节镜下清理术,术前所有患者均有不同程度的疼痛及活动受限,10例患者有关节绞锁病史。术中采用多入路结合清除关节内游离体及病变滑膜。采用改良HSS肘关节评分作为疗效评定标准。结果 15例患者随访2.5～12年(平均5.6年)。肘关节平均伸屈活动范围从术前的(85.6±11.3)°提高到术后的(121.2±10.1)°。肘关节疼痛、肿胀症状减轻,关节绞锁消失。改良HSS评分由术前的(48.2±13.6)分提高到术后的(79.8±12.5)分。6例患者非常满意,7例满意,2例不满意,满意率为86.7%。结论关节镜下关节清理术治疗肘关节滑膜软骨瘤病可取得良好效果,适当的入路选择、规范的镜下操作和病变滑膜的彻底清除是影响疗效和预防复发的关键。
Objective To study the clinical characteristics of synovial chondromatosis of the elbow and assess the diagnostic and therapeutic effects of arthroscopic surgery on the elbow synovial chondromatosis.Methods From January 1997 to January 2007,fifteen patients with elbow synovial chondromatosis were treated with arthroscopic debridement including removal of loose bodies and partial synovectomy.All of the patients had complained of pain and loss of elbow motion,and 10 patients had symptoms of locked joint before operation.The modified HSS elbow rating scale was used as evaluation criterion of the efficacy.Results All patients were followed up for 2.5 years to 12 years （an average of 5.6 years）.The average motion range of flexion-extension was improved from （85.6±11.3）° preoperatively to （121.2±10.1）°.Symptoms of locked joint disappeared in 10 patients.According to the modified HSS elbow rating scale,the score was improved from （48.2±13.6） preoperatively to （79.8±12.5） postoperatively （P0.05）.Six patients were greatly satisfied with the results,seven were satisfied,and two were unsatisfied.The satisfactory rate was 86.7%.ConclusionsArthroscopic surgery is a reliable method in treatment for the elbow synovial chondromatosis.Appropriate selection of approach,standard manipulation,and adequate synovectomy are important for improving the function of the elbow and preventing the recurrence of the synovial chondromatosis.
出处
《中华关节外科杂志（电子版）》
CAS
2010年第4期26-29,共4页
Chinese Journal of Joint Surgery(Electronic Edition)
关键词
肘关节
关节镜
软骨瘤病
滑膜
Elbow joint
Arthroscopes
Chondromatosis, synovial
