Itoh Y, Saegusa K, Ishiguro T, Horiuchi Y, Sasaki T, Uchinishi K
Keiyu Orthopedic Hospital, Gunma, Japan.
Int Orthop. 1989;13(4):263-8. doi: 10.1007/BF00268509.
Forty two cases of stiff elbow were treated by operation. Thirty three were subsequent to trauma, seven were due to ectopic ossification after quadriplegia, and two were associated with massive ectopic ossification after long term coma following head injury. Two separate skin incisions, postero-medial or medial and anterior, were used in most cases. In the post-traumatic cases, scarred, thickened posterior oblique fibres of the medial collateral ligament were usually found. Ectopic ossification was frequently situated on the postero-medial aspect of the stiff elbows. Resection of the thickened fibres or the ectopic ossification was the most effective procedure to improve elbow flexion. The average improvement in range of motion was 59 degrees in post-traumatic cases, 72 degrees in ectopic ossification after quadriplegia and 127 degrees in ectopic ossification following coma.
42例肘关节僵硬患者接受了手术治疗。其中33例继发于创伤,7例因四肢瘫痪后异位骨化,2例与头部受伤后长期昏迷后的大量异位骨化有关。大多数病例采用两个单独的皮肤切口,即后内侧或内侧及前侧。在创伤后病例中,通常发现内侧副韧带的后斜纤维瘢痕化、增厚。异位骨化常位于僵硬肘关节的后内侧。切除增厚的纤维或异位骨化是改善肘关节屈曲最有效的方法。创伤后病例的平均活动范围改善为59度,四肢瘫痪后异位骨化病例为72度,昏迷后异位骨化病例为127度。