Gelinas J J, Faber K J, Patterson S D, King G J
Hand and Upper Limb Centre, St Joseph's Health Centre, University of Western Ontario, London, Canada.
J Bone Joint Surg Br. 2000 Jan;82(1):74-8. doi: 10.1302/0301-620x.82b1.9792.
We have treated 22 patients with an elbow contracture using a static progressive turnbuckle splint for a mean of 4.5 +/- 1.8 months. All had failed to improve with supervised physiotherapy and splinting. The mean range of flexion before splintage was from 32 +/- 10 degrees to 108 +/- 19 degrees and afterwards from 26 + 10 (p = 0.02) to 127 +/- 12 degrees (p = 0.0001). A total of 11 patients gained a 'functional arc of movement,' defined as at least 30 degrees to 130 degrees. In eight patients movement improved with turnbuckle splinting, but the functional arc was not achieved. Six of these were satisfied and did not wish to proceed with surgical treatment and two had release of the elbow contracture. In three patients movement did not improve with the use of the turnbuckle splint and one subsequently had surgical treatment. Our findings have shown that turnbuckle splinting is a safe and effective treatment which should be considered in patients whose established elbow contractures have failed to respond to conventional physiotherapy.
我们使用静态渐进式螺丝扣夹板治疗了22例肘关节挛缩患者，平均治疗时间为4.5±1.8个月。所有患者在接受监督下的物理治疗和夹板固定后均未见改善。夹板固定前的平均屈曲范围为32±10度至108±19度，之后为26 + 10（p = 0.02）至127±12度（p = 0.0001）。共有11例患者获得了“功能性运动弧”，定义为至少30度至130度。8例患者通过螺丝扣夹板固定后运动有所改善，但未达到功能性运动弧。其中6例患者表示满意，不希望进行手术治疗，2例患者进行了肘关节挛缩松解术。3例患者使用螺丝扣夹板后运动未改善，其中1例随后接受了手术治疗。我们的研究结果表明，螺丝扣夹板固定是一种安全有效的治疗方法，对于已确诊的肘关节挛缩对传统物理治疗无反应的患者应予以考虑。
