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关节镜下松解术治疗创伤后肘僵硬。

Arthroscopic arthrolysis for posttraumatic elbow stiffness.

机构信息

Department of Orthopaedic Surgery, Upper-Limb Unit, Amphia Hospital, Breda, The Netherlands.

出版信息

J Shoulder Elbow Surg. 2011 Apr;20(3):434-9. doi: 10.1016/j.jse.2010.11.018.

Abstract

BACKGROUND

Loss of motion of the elbow joint is a common finding after elbow trauma. Restoration of motion of the posttraumatic stiff elbow can be a difficult, time-consuming, and costly challenge. Arthroscopic capsular release of stiff elbows has recently been introduced as a safe but technically demanding technique. The outcome in 27 patients treated by arthroscopic capsular release was assessed.

MATERIALS AND METHODS

We evaluated 27 patients (17 women) who were an average age of 42 years (range, 14-65) at 3, 12, and 24 months after arthroscopic capsular release of a posttraumatic stiff elbow. Range of motion (ROM) and Elbow Function Assessment (EFA) were measured.

RESULTS

Before the arthroscopic procedure, the mean flexion was 123° (SD 8°), extension was 24° (SD 9°), and total ROM was 99° (SD 11°), and after surgery, flexion improved significantly to 133° (SD 5°), extension to 7° (SD 6°), and total ROM to 125° (SD 10°). The mean (SD) EFA showed improvement from 69 (SD 4) preoperatively to 91 (SD 4) postoperatively. The postoperative outcomes at 3, 12 and 24 months were similar. One postoperative superficial infection of the lateral portal occurred and was successfully treated with oral antibiotics. No vascular or neurologic complications were noted.

DISCUSSION

Historical data underscore the fact that arthroscopic release of posttraumatic elbow contracture is technically demanding but can effective improve the elbow arc of motion.

CONCLUSION

Arthroscopic capsular release of the elbow is a safe and reliable treatment for patients with a posttraumatic elbow contracture.

摘要

背景

肘部创伤后常出现关节运动丧失。外伤性僵硬肘部运动的恢复可能是一个困难、耗时且昂贵的挑战。最近,关节镜下囊松解术被引入作为一种安全但技术要求高的技术。评估了 27 例接受关节镜下囊松解术治疗的僵硬肘部患者的结果。

材料和方法

我们评估了 27 例(17 名女性)患者,他们在关节镜下外伤性僵硬肘部囊松解术后 3、12 和 24 个月时的平均年龄为 42 岁(范围 14-65 岁)。测量了关节活动度(ROM)和肘部功能评估(EFA)。

结果

在关节镜手术前,平均屈曲度为 123°(SD 8°),伸展度为 24°(SD 9°),总 ROM 为 99°(SD 11°),手术后,屈曲度显著改善至 133°(SD 5°),伸展度改善至 7°(SD 6°),总 ROM 改善至 125°(SD 10°)。平均(SD)EFA 从术前的 69(SD 4)改善至术后的 91(SD 4)。术后 3、12 和 24 个月的结果相似。外侧入路发生术后浅表感染 1 例,经口服抗生素成功治疗。未发生血管或神经并发症。

讨论

历史数据强调了这样一个事实,即关节镜下释放外伤性肘挛缩技术要求高,但可以有效地改善肘部活动度。

结论

关节镜下囊松解术是治疗外伤性肘挛缩患者的一种安全可靠的方法。

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