Lei Guanghua, Gao Shuguang, Li Kanghua
Department of Orthopaedics, Xiangya Hospital of Central South University, Changsha Hunan, 410008, PR China.
Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2007 Sep;21(9):985-8.
To explore the effect of arthroscopy in diagnosis and treatment of osteochondritis dissecans of elbow joint in adolescent.
From May 2003 to February 2006, 11 patients with osteochondritis dissecans of elbow joint were diagnosed and treated with arthroscopy. There were 6 males and 5 females, aging from 13 to 19 years. The left joints were involved in 4 cases and right joints in 7 cases. Seven patients had obvious history of injury. The interval of injury and operation was from 7 months to 12 years. The score of VAS was 80 +/- 10, the range of flexion and extend of joint 80 +/- 10 degrees, the range of rotation of joint 100 +/- 5 degrees preoperatively. The brachial plexus anesthesia, the elbow hung to traction, soft spot, interna and extra-pathway were given to explore and debride elbow joint and remove corpus liberum.
All patients recovered daily life and work 7 to 12 days postoperatively. There were no complications of blood vessel and nerve injuries. Eleven cases were followed up for 6 to 18 months (mean 12.5 months). The results were excellent in 7 and good in 4 according to HSS scoring system. At the final follow-up, the score of VAS was 32 +/- 15, showing statistically significant difference when compared with pre-operation (P < 0.05). The range of flexion and extend of joint was 110 +/- 10 degrees, the range of rotation of joint was 120 +/- 5 degrees post-operatively, showing statistically significant differences when compared with pre-operation (P < 0.05).
The elbow arthroscopy might be a reliable method to diagnose and treat osteochondritis dissecans of elbow joint in adolescent with minor trauma, quick recovery, significant improving function and less complications.
探讨关节镜在青少年肘关节剥脱性骨软骨炎诊断和治疗中的作用。
2003年5月至2006年2月,对11例肘关节剥脱性骨软骨炎患者行关节镜诊断和治疗。其中男性6例,女性5例,年龄13~19岁。左侧关节4例,右侧关节7例。7例有明确外伤史。受伤至手术时间7个月至12年。术前视觉模拟评分(VAS)为80±10分,关节屈伸范围80±10度,关节旋转范围100±5度。采用臂丛麻醉,肘关节悬吊牵引,经软点、内侧及外侧入路探查清理肘关节,摘除游离体。
所有患者术后7~12天恢复日常生活及工作。无血管、神经损伤等并发症。11例患者随访6~18个月(平均12.5个月)。根据HSS评分系统,优7例,良4例。末次随访时,VAS评分为32±15分,与术前比较差异有统计学意义(P<0.05)。术后关节屈伸范围为110±10度,关节旋转范围为120±5度,与术前比较差异有统计学意义(P<0.05)。
肘关节镜检查可能是诊断和治疗青少年肘关节剥脱性骨软骨炎的可靠方法,具有创伤小、恢复快、功能改善明显、并发症少等优点。