Pennig Dietmar, Mader Konrad, Heck Steffen
St. Vinzenz-Hospital Köln, Akademisches, Lehrkrankenhaus der Universität zu Köln, Köln, Germany.
Oper Orthop Traumatol. 2009 Dec;21(6):521-32. doi: 10.1007/s00064-009-2002-2.
Loss of motion of the elbow is not uncommon after trauma, burns, or coma and severely impairs upper limb function. Loss of motion may be difficult to avoid and is challenging to treat. Detailed analysis of the etiology and diagnostic evaluation are of utmost importance for planning any surgical intervention for elbow stiffness. Most activities of daily living are possible, if the elbow has a range of motion of 100 degrees (30-130 degrees of flexion, Morrey's arc of motion).
Stiff elbow, usually defined as less than 30 degrees extension or less than 130 degrees flexion.
Poor compliance, poorly controlled diabetes mellitus, active hepatitis B and C infection, HIV infection, acute articular infection.
Current operative techniques, such as closed distraction with external fixation (arthrodiatasis), are presented and evaluated. Elbow arthrolysis is a technically demanding procedure.
If indication and techniques are used correctly and surgeon, physiotherapist, and patient are familiar with the procedure, good long-term results may be achieved.
In 14 children and adolescents the results after 5 years showed an increase of preoperative range of motion from 37 degrees to 108 degrees (flexion/extension; 75-130 degrees ) postoperatively.
肘部活动丧失在创伤、烧伤或昏迷后并不少见，会严重损害上肢功能。活动丧失可能难以避免且治疗具有挑战性。对病因进行详细分析和诊断评估对于规划肘部僵硬的任何手术干预至关重要。如果肘部有100度的活动范围（屈曲30 - 130度，莫雷活动弧），大多数日常生活活动都是可行的。
肘关节僵硬，通常定义为伸展小于30度或屈曲小于130度。
依从性差、糖尿病控制不佳、活动性乙型和丙型肝炎感染、艾滋病毒感染、急性关节感染。
介绍并评估了当前的手术技术，如外固定闭合牵张术（关节扩张术）。肘关节松解术是一项技术要求很高的手术。
如果适应症和技术使用正确，并且外科医生、物理治疗师和患者熟悉该手术过程，可能会取得良好的长期效果。
14名儿童和青少年术后5年的结果显示，术前活动范围从37度增加到术后的108度（屈曲/伸展；75 - 130度）。
