Manske P R, Langewisch K R, Strecker W B, Albrecht M M
Shriners Hospitals for Children, St. Louis, Missouri, USA.
J Pediatr Orthop. 2001 Nov-Dec;21(6):772-7.
This study evaluated anterior elbow release for spastic elbow flexion deformity in children with cerebral palsy. Forty-two consecutive surgical procedures are reported in 40 children with a minimum of 1 year of follow-up. The procedure included incision of the lacertus fibrosus, fractional lengthening of the brachialis aponeurosis, and denuding the peritendinous adventitia from the biceps tendon to remove afferent nerve fibers and receptors. Preoperative and postoperative measurements of the flexion posture angle, active extension, and active flexion were obtained, as well as completion of a written questionnaire by the parents. Flexion posture angle improved from 104 degrees before surgery to 55 degrees after surgery, a reduction of 49 degrees; active extension improved from 43 degrees to 27 degrees. There was no significant change in elbow flexion. Before surgery, the average percentage use of the arm was 12%, which improved significantly to 44% after surgery. The authors conclude that anterior elbow release can significantly improve the flexion posture angle and active extension of the elbow, as well as both the functional use and aesthetic appearance of the involved upper limb.
本研究评估了针对脑瘫患儿痉挛性肘屈曲畸形的肘前松解术。报告了40例患儿连续进行的42例外科手术，随访时间至少1年。该手术包括切开肱二头肌腱膜、部分延长肱肌肌腱膜，以及从肱二头肌肌腱上剥除腱周外膜以去除传入神经纤维和感受器。术前和术后均测量了屈曲姿势角度、主动伸展和主动屈曲情况，同时还让家长完成了一份书面问卷。屈曲姿势角度从术前的104度改善至术后的55度，减少了49度；主动伸展从43度改善至27度。肘屈曲无显著变化。术前，患侧手臂的平均使用百分比为12%，术后显著提高至44%。作者得出结论，肘前松解术可显著改善肘部的屈曲姿势角度和主动伸展，以及受累上肢的功能使用和美观度。
