Kolb K, Koller H, Holz U, Kolb W, Windisch C, Markgraf E, Grützner P A
Klinik für Unfall- und Wiederherstellungschirurgie, Katharinenhospital Stuttgart, Stuttgart, Germany.
Unfallchirurg. 2008 May;111(5):299-307. doi: 10.1007/s00113-008-1408-x.
The incidence of relevant posttraumatic functional deficits in the sense of elbow stiffness with less than 30 degrees in extension or flexion less than 120 degrees , is unknown. A differentiation can be made between intraarticular, extraarticular and combined causes. An open procedure is indicated in elbow stiffness after correct analysis of the situation and failure of conservative treatment.
An open procedure was carried out on 35 patients between March 1995 and November 2001, 10 (3-24) months after the trauma. The mean age of the 24 men and 11 women was 45 (range 17-75) years. Of the patients 15 had distal humerus fractures, 10 radius head or neck fractures and 12 proximal ulnar fractures.
Of the patients 11 (31%) had an excellent result in the Cauchoix and Deburge score, 15 (42%) a good, 4 (11%) a fair, 4 (11%) a bad and 1 (3%) a very bad result after a mean follow-up of 21.5 (range 9-60) months. Of the patients 11 (31%) had an excellent result in the Mayo elbow performance score, 14 (40%) a good, 5 (14%) a fair and 5 (14%) a poor result.
Open arthrolysis for severe posttraumatic elbow stiffness carried out 10 months (range 3-24 months) after the accident led to good results in most cases with a clear improvement in functional mobility.
创伤后出现肘关节僵硬，伸展小于30度或屈曲小于120度的相关功能障碍的发生率尚不清楚。病因可分为关节内、关节外及合并性。经正确评估病情且保守治疗失败后，对于肘关节僵硬需采用切开手术。
1995年3月至2001年11月期间，对35例患者进行了切开手术，手术在创伤后10（3 - 24）个月进行。24名男性和11名女性的平均年龄为45（17 - 75）岁。其中15例为肱骨远端骨折，10例为桡骨头或颈骨折，12例为尺骨近端骨折。
平均随访21.5（9 - 60）个月后，根据Cauchoix和Deburge评分，11例（31%）患者结果为优，15例（42%）为良，4例（11%）为中，4例（11%）为差，1例（3%）为极差。根据Mayo肘关节功能评分，11例（31%）患者结果为优，14例（40%）为良，5例（14%）为中，5例（14%）为差。
事故发生10个月（3 - 24个月）后对严重创伤后肘关节僵硬进行切开松解术，多数情况下效果良好，功能活动有明显改善。
