Marti René K, Kerkhoffs Gino M M J, Maas Mario, Blankevoort Leendert
Department of Orthopedic Surgery, Academic Medical Center, Amsterdam, The Netherlands.
Acta Orthop Scand. 2002 Apr;73(2):144-50. doi: 10.1080/000164702753671713.
We treated 46 consecutive patients (47 elbows) suffering from posttraumatic contracture of the elbow joint with operative release. A lateral approach was used to perform a capsulectomy after release of the extensor muscles in 23 elbows. An additional medial approach was used to excise ulnar adhesions and perform a more extensive capsulectomy and an ulnar nerve neurolysis in 24 elbows. Postoperative rehabilitation consisted of immediate passive range-of-motion exercises. The results were assessed after average 10 (2-18) years. Before surgery, the mean active arc of motion was 45 (SD 36) degrees, which improved to 99 (SD 34) degrees after release. 7 patients had transient ulnar paresthesia, 4 recurrent stiffness, which did not become worse after surgery, 1 was reoperated on and 2 developed a postoperative infection, which responded to antibiotic treatment after a few months. No patient suffered from joint instability, or an increase in pain. 44 patients were satisfied with the result at the latest follow-up. We found similar improvement in both treatment groups.
我们对46例连续性创伤后肘关节挛缩患者（47个肘关节）实施了手术松解治疗。采用外侧入路对23个肘关节的伸肌进行松解后行关节囊切除术。另外24个肘关节采用内侧入路切除尺侧粘连，并进行更广泛的关节囊切除和尺神经松解术。术后康复包括立即进行被动活动度练习。平均随访10（2 - 18）年后评估结果。术前，平均主动活动弧度为45（标准差36）度，松解后改善至99（标准差34）度。7例患者出现短暂性尺侧感觉异常，4例出现复发性僵硬，但术后未加重，1例行再次手术，2例发生术后感染，数月后经抗生素治疗后好转。无患者出现关节不稳定或疼痛加剧。在最近一次随访时，44例患者对结果满意。我们发现两个治疗组均有相似程度的改善。
