Division of Orthopedics, University of Calgary, Calgary, Alberta, Canada.
J Shoulder Elbow Surg. 2011 Jan;20(1):39-44. doi: 10.1016/j.jse.2010.07.013. Epub 2010 Nov 3.
The purpose of the study was to follow elbow range of motion for 1 year after injury and to document the rate of secondary intervention due to joint contracture.
We prospectively followed up 25 subjects with traumatic elbow injuries. Data were collected up to 52 weeks after injury. Injuries at the elbow included fractures, elbow dislocations, fracture-dislocations, and biceps tendon ruptures. Subjects were treated as their injury necessitated, with a rehabilitation protocol for each injury type.
There was significant improvement for all range-of-motion measures for the time course to 1-year follow up (P < .05). At 1 year, 22 of 25 subjects achieved a flexion-extension arc greater than 100°. At 1 year, 24 of 25 subjects achieved a pronation-supination arc greater than 100°. Reoperation was performed in 5 of 25 subjects; in 3 of which, this was because of elbow joint contracture.
Traumatic elbow injuries carry a risk of joint contracture, 12% of our subjects did not regain a functional range of motion, and 12% had a joint contracture that required reoperation. Range of motion continues to improve up to 1 year after injury; failure to progress 3 months after injury suggests impending elbow joint contractures.
本研究的目的是随访创伤性肘部损伤后 1 年的关节活动度,并记录因关节挛缩而进行二次干预的发生率。
我们前瞻性随访了 25 例创伤性肘部损伤患者。数据收集时间最长达损伤后 52 周。肘部损伤包括骨折、肘关节脱位、骨折脱位和肱二头肌肌腱断裂。根据损伤类型为每位患者制定了康复方案。
在整个 1 年的随访过程中,所有运动范围测量值均有显著改善(P <.05)。1 年后,25 例患者中有 22 例屈-伸弧大于 100°。1 年后,25 例患者中有 24 例旋前-旋后弧大于 100°。25 例患者中有 5 例进行了再次手术,其中 3 例是由于肘关节挛缩。
创伤性肘部损伤存在关节挛缩的风险,我们的 12%的患者没有恢复到功能运动范围,12%的患者发生了需要再次手术的关节挛缩。运动范围在损伤后 1 年内持续改善;损伤后 3 个月无进展提示即将发生肘关节挛缩。