Ball Craig M, Meunier Matthew, Galatz Leesa M, Calfee Ryan, Yamaguchi Ken
Department of Orthopaedic Surgery, Barnes-Jewish Hospital at Washington University School of Medicine, St Louis, MO 63110, USA.
J Shoulder Elbow Surg. 2002 Nov-Dec;11(6):624-9. doi: 10.1067/mse.2002.126770.
The purpose of this study was to evaluate range of motion and patient-reported outcome after complete arthroscopic release of post-traumatic elbow contracture. Fourteen consecutive patients who underwent elbow arthroscopy and capsular release were reviewed retrospectively at a minimum follow-up of 1 year. Pain and range of motion were measured. Patient outcome was assessed with the American Shoulder and Elbow Surgeons Elbow Assessment Form. Mean self-reported satisfaction on a visual analog scale was 8.4 out of 10. Only 6 patients continued to have pain, with a mean maximum pain score of 4.6 out of 10. Flexion increased from a mean of 117.5 degrees to 133 degrees, and extension improved from a mean of 35.4 degrees to 9.3 degrees. In those patients with a preoperative arc of motion less than 100 degrees (10 patients), the mean arc of motion improved from 69 degrees to 119 degrees. All patients had improved function after the procedure, with a mean self-reported functional ability score of 28.3 out of 30. There were no neurovascular complications. The improvement in range of motion and functional outcome compares favorably with open-release procedures. Combined with the potential benefits of improved joint visualization and low surgical morbidity, arthroscopic release of post-traumatic elbow contracture appears to be a reasonable alternative to open techniques.
本研究的目的是评估创伤后肘关节挛缩完全关节镜下松解术后的活动范围及患者报告的结果。对14例连续接受肘关节镜检查及关节囊松解术的患者进行回顾性分析，最小随访时间为1年。测量疼痛及活动范围。采用美国肩肘外科医师协会肘关节评估表评估患者结果。视觉模拟量表上患者自我报告的平均满意度为8.4分（满分10分）。仅有6例患者持续存在疼痛，平均最大疼痛评分为4.6分（满分10分）。屈曲角度从平均117.5度增加至133度，伸展角度从平均35.4度改善至9.3度。在术前活动弧度小于100度的患者（10例）中，平均活动弧度从69度改善至119度。所有患者术后功能均有改善，自我报告的平均功能能力评分为28.3分（满分30分）。无神经血管并发症。活动范围及功能结果的改善与开放松解手术相比具有优势。结合改善关节可视化的潜在益处及较低的手术发病率，创伤后肘关节挛缩的关节镜下松解似乎是开放技术的合理替代方法。
