Schippinger G, Seibert F J, Steinböck J, Kucharczyk M
Department of Traumatology, Karl Franzens University School of Medicine, Graz, Austria.
Langenbecks Arch Surg. 1999 Jun;384(3):294-7. doi: 10.1007/s004230050206.
Forty-five patients with a simple elbow dislocation were re-examined at an average time of 61 months after injury. All patients were treated by means of closed reduction. Only patients with minor associated injuries were included in the study. The Morrey score was used to evaluate pain, limitation of motion, instability, and daily activities. The overall results were good or excellent with regard to pain and function. The most common finding was a loss of terminal extension. Nine percent of all patients had a lack of extension up to 30 degrees, while 36% had a flexion contracture of less than 10 degrees. Periarticular ossification was seen in 28 patients, but did not lead to loss of motion. For further analysis, the patients were divided into three groups of immobilization: group I, less than 2 weeks, group II, 2-3 weeks, and group III, more than 3 weeks.
We encountered better results from those in groups I and II with regard to pain and score results without any statistical significance.
Our results suggest that splintage of the reduced elbow for 2 weeks enhances patient comfort and does not adversely affect the eventual outcome. Splintage for over 3 weeks may result in worse function.
45例单纯肘关节脱位患者在受伤后平均61个月时接受复查。所有患者均采用闭合复位治疗。本研究仅纳入伴有轻微合并伤的患者。采用Morrey评分评估疼痛、活动受限、不稳定及日常活动情况。疼痛和功能方面的总体结果为良好或优秀。最常见的表现是终末伸展丧失。所有患者中有9%伸展缺失达30度，而36%有小于10度的屈曲挛缩。28例患者出现关节周围骨化，但未导致活动丧失。为进一步分析，将患者分为三组固定情况：I组，固定时间少于2周；II组，固定2 - 3周；III组，固定超过3周。
I组和II组患者在疼痛和评分结果方面有更好的表现，但无统计学意义。
我们的结果表明，复位后的肘关节固定2周可提高患者舒适度，且不会对最终结果产生不利影响。固定超过3周可能导致功能更差。
