Jiang Xie-Yuan, Zhang Li-Dan, Liu Xing-Hua, Huang Lei, Wei Jie, Wang Man-Yi, Rong Guo-Wei
Department of Orthopaedic Trauma, Beijing Jishuitan Hospital, Beijing 100035, China.
Zhonghua Wai Ke Za Zhi. 2004 Jun 22;42(12):737-40.
To introduce a new way of treatment for elbow stiffness and instability.
30 cases of elbow trauma were treated with mobile hinged Orthofix elbow fixator, 26 of them were followed up. There are 15 male patients and 11 female patients. The average age is 32.6 years old. The 26 injured elbows involved 12 cases on left side and 14 cases on right side; Sixteen cases on the dominant side and 10 cases on the non-dominant side. Sixteen cases had elbow stiffness, 5 cases had acute radial head fracture and posterior dislocation of the elbow, 3 of cases had Monteggia's fracture dislocation, and 2 cases had neglected posterior dislocation of the elbow.
The average follow up time was 6 months (3 - 12 month). The mean time of fixation with fixator was 8.5 weeks (6 - 11 weeks). The mean ROM of the 16 cases of elbow stiffness was (37.5 +/- 0.8) degrees before operation, and (96.5 +/- 0.6) degrees operation, with a significant difference (P < 0.05). The mean Mayo elbow score was (69.5 +/- 1.7) before operation, compared with (82.8 +/- 1.6) after operation, with a significant difference (< 0.05). For the other 10 cases (5 cases with acute radial head fracture and posterior dislocation of the elbow, 3 cases with Monteggia's fracture dislocation, 2 cases with neglected posterior dislocation of the elbow), the average ROM of the elbow flexion-extension was 95 degrees (65 degrees - 150 degrees ); The average range of flexion was 117 degrees; the average loss of extension was 22 degrees; the average pronation was 76 degrees (20 degrees - 90 degrees ), the average supination was 75 degrees (15 degrees - 90 degrees ). Nine of the cases achieved anatomic reduction and proved by X-ray. The mean Mayo elbow score was 84 (49 - 96). Three cases were rated excellent, 4 good, 2 fair and 1 poor. The rate of excellent and good was 70% (7/10). Nine cases had no pain or mild pain, and did not need analgesic. Eight cases returned to their former work, 5 of the cases had complications.
The mobile hinged elbow external fixator have following advantages: (1) distraction of the articular space and enhance fracture healing; (2) allow early movement of the elbow during healing; (3) provide stable environment for the healing after arthrolysis and reconstruction. Mobile hinged elbow external fixator can achieve successful result in the treatment of elbow stiffness or unstable fracture dislocation of elbow.
介绍一种治疗肘关节僵硬和不稳定的新方法。
应用Orthofix活动铰链式肘关节固定器治疗30例肘关节创伤患者，其中26例获得随访。男性15例，女性11例。平均年龄32.6岁。26个受伤肘关节中，左侧12例，右侧14例；优势侧16例，非优势侧10例。肘关节僵硬16例，急性桡骨头骨折合并肘关节后脱位5例，孟氏骨折脱位3例，陈旧性肘关节后脱位2例。
平均随访时间6个月（3 - 12个月）。固定器平均固定时间8.5周（6 - 11周）。16例肘关节僵硬患者术前平均活动度为（37.5±0.8）度，术后为（96.5±0.6）度，差异有统计学意义（P < 0.05）。术前平均Mayo肘关节评分（69.5±1.7）分，术后为（82.8±1.6）分，差异有统计学意义（< 0.05）。另外10例（急性桡骨头骨折合并肘关节后脱位5例，孟氏骨折脱位3例，陈旧性肘关节后脱位2例），肘关节屈伸平均活动度为95度（65度 - 150度）；平均屈曲范围为117度；平均伸直丢失为22度；平均旋前为76度（20度 - 90度），平均旋后为75度（15度 - 90度）。9例达到解剖复位并经X线证实。平均Mayo肘关节评分为84分（49 - 96分）。优3例，良4例，可2例，差1例。优良率为70%（7/10）。9例无疼痛或轻度疼痛，无需止痛。8例恢复原工作，5例出现并发症。
活动铰链式肘关节外固定器具有以下优点：（1）撑开关节间隙，促进骨折愈合；（2）允许肘关节在愈合过程中早期活动；（3）为关节松解和重建术后的愈合提供稳定环境。活动铰链式肘关节外固定器在治疗肘关节僵硬或不稳定骨折脱位方面可取得成功疗效。
