Duke J B, Tessler R H, Dell P C
Department of Orthopaedics, University of Florida, Gainesville 32610.
J Hand Surg Am. 1991 Jan;16(1):19-24. doi: 10.1016/s0363-5023(10)80005-x.
Eleven patients had elbow manipulation under general anesthesia to improve a dysfunctional range of motion. Six (55%) patients improved their motion, three (27%) patients had no significant change, and two (18%) patients lost motion. Type of injury, extremity dominance, previous surgical procedures, delay to manipulation, or use of postoperative steroid injections and continuous passive motion did not correlate with successful results. Two transient sensory ulnar neuropathies were the only complications and no heterotopic bone formation or exacerbation was observed. Manipulation under anesthesia should be considered in patients with a dysfunctional elbow range of motion after failure of well-supervised rehabilitation.
11例患者在全身麻醉下进行了肘部手法操作,以改善活动范围功能障碍。6例(55%)患者的活动得到改善,3例(27%)患者无明显变化,2例(18%)患者活动度下降。损伤类型、肢体优势、既往手术操作、手法操作延迟、术后是否使用类固醇注射及持续被动活动与成功结果均无相关性。仅出现2例短暂性尺神经感觉神经病变,未观察到异位骨化或病情加重。对于在经过良好监督的康复治疗失败后出现肘部活动范围功能障碍的患者,应考虑进行麻醉下手法操作。