Burkhart K J, Dargel J, Wegmann K, Müller L P
Klinik und Poliklinik für Orthopädie und Unfallchirurgie, Universitätsklinikum Köln, Kerpener Straße 62, 50937 Köln.
Unfallchirurg. 2013 Apr;116(4):371-5. doi: 10.1007/s00113-012-2184-1.
A 44-year-old patient was treated with elbow arthrodesis at a position of 90° due to primary osteoarthritis. Seven years later he was introduced to us due to progressive pain of both elbows. Although the arthrodesis had consolidated uneventfully, the patient felt massive restrictions due to eliminated extension/flexion and persistent pain. The right elbow developed primary osteoarthritis likewise. We performed arthroscopic debridement and arthrolysis of the right elbow. After a recovery phase of 2 months we converted the arthrodesis of the left elbow to total elbow arthroplasty. Three months later he achieved active flexion/extension of 0-30-100°, had no pain and was able to perform most activities of daily living again with his left elbow. Movement against resistance was possible, whereas strength was limited compared to the right side. After 9 months the flexion-extension arc was 0-25-110°. This case shows that conversion of arthrodesis to arthroplasty is possible at the elbow. Despite the long arthrodesis period of 7 years the patient was able to activate the elbow extensors and flexors.
一名44岁的患者因原发性骨关节炎在90°位进行了肘关节融合术。七年后，由于双肘渐进性疼痛，他前来我院就诊。尽管肘关节融合术顺利愈合，但由于屈伸功能丧失和持续疼痛，患者感到活动严重受限。右侧肘关节同样出现了原发性骨关节炎。我们对右侧肘关节进行了关节镜下清理和粘连松解术。经过2个月的恢复阶段后，我们将左侧肘关节融合术改为全肘关节置换术。三个月后，他左侧肘关节的主动屈伸范围达到了0-30-100°，无痛感，并且能够再次进行大部分日常生活活动。抗阻运动可行，但与右侧相比力量有限。9个月后，屈伸弧度为0-25-110°。该病例表明，肘关节融合术可以转换为关节置换术。尽管肘关节融合术长达7年，但患者仍能够激活肘部伸肌和屈肌。
