Park M J, Kim H G, Lee J Y
Department of Orthopaedic Surgery, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Kangnam-ku, Seoul 135-710, Korea.
J Bone Joint Surg Br. 2004 Nov;86(8):1158-62. doi: 10.1302/0301-620x.86b8.14962.
Surgical release of the elbow was performed in 27 patients with post-traumatic stiffness at a mean of 14.5 months after the initial injury. The outcome was related to whether there had been heterotopic ossification, which had occurred in 18 elbows and to whether, if there had been a fracture, it had involved the articular surface, which had occurred in 13 elbows. The final range of movement and the ratio of desired gain in each group were compared at a mean follow-up period of 22.5 months (12 to 43). The arc of movement of the elbow improved in all patients after the operation. The mean final arc was 110 degrees in those with heterotopic ossification and 86 degrees in those without (p = 0.001). The ratios of desired gain were significantly higher in patients with heterotopic ossification (88.2% vs 54.9%; p < 0.001). There was no significant difference in relation to involvement of the articular surface. Careful assessment of the cause of stiffness is important in order to achieve a satisfactory result from surgery for post-traumatic stiffness of the elbow.
对27例创伤后肘关节僵硬患者进行了手术松解，手术时间平均为初次受伤后14.5个月。结果与是否存在异位骨化有关，18例肘关节出现了异位骨化，还与是否发生骨折（13例肘关节骨折累及关节面）有关。在平均22.5个月（12至43个月）的随访期内，比较了每组的最终活动范围和预期改善率。术后所有患者的肘关节活动弧度均有改善。有异位骨化患者的平均最终活动弧度为110度，无异位骨化患者为86度（p = 0.001）。异位骨化患者的预期改善率显著更高（88.2%对54.9%；p < 0.001）。关节面受累情况无显著差异。为了使创伤后肘关节僵硬手术取得满意效果，仔细评估僵硬原因很重要。
