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[挛缩肘关节的人工关节置换术]

[Endoprosthetic joint replacement of the contracted elbow joint].

作者信息

Mansat P, Morrey B F

机构信息

Service d'Orthopédie et Traumatologie, Hôpital Universitaire de Toulouse-Purpan, Place du Dr Baylac, F-31059 Toulouse, France.

出版信息

Orthopade. 2001 Sep;30(9):645-8. doi: 10.1007/s001320170052.

Abstract

In a retrospective study 14 patients were reviewed 63 months after the implantation of a semi-constrained total elbow prosthesis in fourteen stiff or ankylosed elbows with a preoperative range of elbow motion of 30 degrees or less. The result, according to the Mayo Elbow Performance score, was excellent for four elbows, good for four, fair for one, and poor for five. The average arc of flexion improved from 7 to 68 degrees postoperatively with an average increase of 34 degrees in flexion, and 27 degrees in extension. There were seven complications affecting seven of the 14 elbows and four of these seven elbows underwent a revision procedure. Replacement for a stiff elbow is the least predictable, has the lowest overall rate of success and highest complication rate, than any other procedure. Nevertheless, these disadvantages must be placed in the context of alternative intervention options. The semiconstrained total elbow arthroplasty seems to be a useful option for patients older than 50 years with intrinsic stiffness involving more than 50% of the articular surface and with an ankylosed or very stiff elbow.

摘要

在一项回顾性研究中,对14例患者进行了评估,这些患者在植入半限制性全肘关节假体63个月后,术前肘关节活动范围为30度或更小,肘关节僵硬或强直。根据梅奥肘关节功能评分,结果为4例肘关节优,4例良,1例可,5例差。术后平均屈曲弧度从7度提高到68度,平均屈曲增加34度,伸展增加27度。14例肘关节中有7例出现并发症,其中7例中的4例接受了翻修手术。与其他任何手术相比,置换僵硬肘关节的可预测性最低,总体成功率最低,并发症发生率最高。然而,这些缺点必须结合其他干预选项来考虑。对于年龄超过50岁、内在僵硬累及超过50%关节面且肘关节强直或非常僵硬的患者,半限制性全肘关节置换术似乎是一种有用的选择。

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