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创伤后肘关节僵硬行后路开放性肘关节松解术后的临床疗效

Clinical outcomes after posterior open elbow arthrolysis for posttraumatic elbow stiffness.

作者信息

Birjandi Nejad Ali, Ebrahimzadeh Mohammad Hosein, Moradi Ali

机构信息

Orthopedic Research Center, Shahid Kamyab Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.

Orthopedic Research Center, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, IR Iran.

出版信息

Arch Trauma Res. 2014 Sep 30;3(3):e21742. doi: 10.5812/atr.21742. eCollection 2014 Sep.

Abstract

BACKGROUND

Loss of motion is a well-known complication after elbow trauma and in severe cases, arthrolysis of elbow is the procedure of choice. The posterior approach might have some advantages especially in post-traumatic patients who have undergone the same surgical approach in the past.

OBJECTIVES

The aim of this study was to evaluate the short-term outcomes of elbow arthrolysis through posterior approach. Moreover, we assessed the effect of operation on the patients' quality of life.

PATIENTS AND METHODS

During a retrospective-cohort study, the medical records of 14 patients (12 men, two women) whose range of movement had been limited post-traumatically and had undergone elbow arthrolysis with posterior approach were reviewed. Before intervention, the patients had a flexion less than 100 degrees or an extension lag of 30 degrees or more. For evaluation of the final outcomes, they were invited to participate in our study and the final range of motion, visual analogue score (VAS), disability of arm, shoulder and hand (DASH), Mayo elbow score (MES) and short form health survey (SF-36) scores were measured in the patients.

RESULTS

Mean age of the participants was 28.7 years. The interval from initial injury and arthrolysis was 16 months and the patients were followed for 14 months. The mean range of motion in patients before surgery was 35.8 degrees, which was increased to a mean of 108.9 after the surgery, indicating a 73.1 degrees improvement. The means of VAS, DASH, Mayo elbow and SF-36 scores in the patients were 1.6, 34, 68 and 43, respectively. A significant inverse correlation was found between the preoperative range of motion and final range of motion.

CONCLUSIONS

According to our results, elbow arthrolysis through posterior approach could be an effective technique with low complications. Since the final range of motion improved significantly, it might be a valuable method in promoting the patients' quality of life.

摘要

背景

活动受限是肘部创伤后一种众所周知的并发症,在严重病例中,肘关节松解术是首选的治疗方法。后路手术可能具有一些优势,特别是对于既往接受过相同手术入路的创伤后患者。

目的

本研究旨在评估后路肘关节松解术的短期疗效。此外,我们还评估了手术对患者生活质量的影响。

患者与方法

在一项回顾性队列研究中,我们回顾了14例(12例男性,2例女性)创伤后活动范围受限且接受过后路肘关节松解术患者的病历。干预前,患者的屈曲度小于100度或伸直滞后30度或更多。为了评估最终疗效,邀请他们参与我们的研究,并测量患者的最终活动范围、视觉模拟评分(VAS)、上肢、肩部和手部功能障碍(DASH)、梅奥肘关节评分(MES)和简短健康调查问卷(SF-36)评分。

结果

参与者的平均年龄为28.7岁。从初次受伤到进行肘关节松解术的间隔时间为16个月,患者随访了14个月。患者术前的平均活动范围为35.8度,术后增加到平均108.9度,改善了73.1度。患者的VAS、DASH、梅奥肘关节和SF-36评分的平均值分别为1.6、34、68和43。术前活动范围与最终活动范围之间存在显著的负相关。

结论

根据我们的结果,后路肘关节松解术可能是一种并发症发生率低的有效技术。由于最终活动范围有显著改善,它可能是提高患者生活质量的一种有价值的方法。

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本文引用的文献

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Continuous passive motion following elbow arthrolysis.肘关节松解术后持续被动活动
J Hand Surg Am. 2014 Feb;39(2):350-2. doi: 10.1016/j.jhsa.2013.11.040.
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Surgical treatment of post-traumatic elbow stiffness: a systematic review.创伤后肘关节僵硬的手术治疗:系统评价。
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Elbow arthrolysis in severely stiff elbows.严重僵硬肘关节的关节松解术
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Functional outcome of complex intercondylar fractures of the distal humerus treated through a triceps-sparing approach.
J Shoulder Elbow Surg. 2008 May-Jun;17(3):441-6. doi: 10.1016/j.jse.2007.08.012. Epub 2008 Feb 20.
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The posttraumatic stiff elbow: a review of the literature.创伤后肘关节僵硬:文献综述
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