Singh Harpreet, Nam Ki Young, Moon Young Lae
Department of Orthopedics, Chosun University Hospital, Gwangju, South Korea.
Orthopedics. 2011 Jun 14;34(6):167. doi: 10.3928/01477447-20110427-16.
Elbow stiffness is a common problem encountered by orthopedic surgeons. Various management options have been described in the literature, including conservative measures and open and arthroscopic surgery. Arthroscopic management of stiff elbow remains controversial. The purpose of this study was to evaluate the functional results of arthroscopic management of stiff elbow.Thirty patients with stiff elbow underwent arthroscopic release surgery and were followed up for an average of 27.3 months. Surgery included anterior and posterior capsular release, coronoid process debridement, bony spur excision, and loose body removal. Postoperative outcome was assessed using the Mayo Elbow Performance Score and range of motion at the elbow. Mayo Elbow Performance Score increased from a mean 64.5 preoperatively to a mean 83.17 postoperatively. Range of motion also improved, from a mean preoperative extension and flexion of 22.83° and 96.83°, respectively, vs a mean 10.83° and 120.84°, respectively, at final follow-up. No intra- or postoperative complication was seen in any case. Underlying etiology and timing of surgery influenced the end result, with better results seen in patients with traumatic etiology and those with a shorter duration of symptoms.Arthroscopic release allows good visualization and rectification of intra-articular pathology and is a safe and effective tool for the management of stiff elbow.
肘关节僵硬是骨科医生常遇到的问题。文献中描述了多种治疗方法,包括保守治疗以及开放手术和关节镜手术。关节镜治疗僵硬肘关节仍存在争议。本研究的目的是评估关节镜治疗僵硬肘关节的功能结果。30例肘关节僵硬患者接受了关节镜下松解手术,平均随访27.3个月。手术包括前后关节囊松解、冠状突清创、骨赘切除和游离体摘除。术后结果采用Mayo肘关节功能评分和肘关节活动度进行评估。Mayo肘关节功能评分从术前平均64.5分提高到术后平均83.17分。活动度也有所改善,术前平均伸展和屈曲度分别为22.83°和96.83°,末次随访时分别为10.83°和120.84°。所有病例均未出现术中或术后并发症。潜在病因和手术时机影响最终结果,创伤性病因患者和症状持续时间较短的患者结果更好。关节镜下松解能很好地观察和纠正关节内病变,是治疗僵硬肘关节的一种安全有效的方法。