摘要
目的:探讨开放肘关节松解术治疗肘关节僵硬患者的要点和疗效。方法:2007年8月至2012年4月,采用开放肘关节松解手术治疗17例肘关节僵硬患者,其中创伤后僵硬11例、类风湿性关节炎及退变性关节炎所致肘关节僵硬6例。术前Mayo肘关节功能评分为(65.1±16.4)分。15例采用后正中入路,2例采用前次手术的原外侧切口。对明显屈曲受限的12例患者采用了尺神经前移,对于清除完严重异位骨化后不稳定的2例患者采用了铰链式外固定架。结果:平均随访时间13.1个月(6～41个月),17例均获随访。末次随访时Mayo肘关节功能评分为(87.5±16.7)分,与术前比较差异有统计学意义(P<0.001);17例患者中,优9例、良6例、可1例、差1例,优良率为88.23%。主动屈伸活动度范围达到110.6°±27.5°。1例患者术后发生慢性感染,1例患者术后出现了尺神经症状。结论:应用开放性肘关节松解术治疗肘关节僵硬患者,只要能松解彻底,又能保证肘关节的稳定性和早期活动,即可获得满意疗效。
Objective：To investigate the treatment effect of open arthrolysis for elbow stiffness.Methods：From Aug.2007 to Apr.2012,17 cases of elbow stiffness were treated with open arthrolysis,in which,11 were post-traumatic stiffness and 6 elbow stiffness resulted from rheumatoid arthritis and osteoarthritis.The pre-operative Mayo elbow score was 65.1±16.4.Posterior middle approach was applied for 15 cases,and primary lateral approach for 2 cases.The ulnar nerve release and antedisplacement were performed for 12 cases with series limited flexion.The mobile hinged fixator were applied for 2 cases of unstable elbow after debridement of series hero ossification.Results：With follow-up time for 6 to 41 months（average 13.1 months）,all the patients acquired the follow-up and evaluation.According to Mayo elbow score of the last follow-up,the score was 87.5±16.7,and compared with the pre-operation,the difference was significant：9 cases were excellent,6 good,1 fair,and 1 poor,and the total excellent and good rate was 88.23%.The active range of motion（ROM） of flexion-extension was 110.6°±27.5°.However,1 case developed chronic infection,and 1 ulnar nerve symptom.Conclusion：In applying open arthrolysis to treat elbow stiffness,as long as we release completely and assure stable elbow and early post-operative motion,we can get satisfying results.
出处
《北京大学学报（医学版）》
CAS
CSCD
北大核心
2012年第6期870-873,共4页
Journal of Peking University:Health Sciences
基金
卫生公益性行业科研专项(201002014)
北京大学人民医院研究与发展基金(RDC2010-01)
北京市科技支撑
市政府重点工作项目(Z101107052210001)资助~~
