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近期肘关节脱位的治疗:功能治疗与固定;一项关于60例病例的前瞻性研究

Management Of Recent Elbow Dislocations: Functional Treatment Versus Immobilization; A Prospective Study About 60 Cases.

作者信息

Coulibaly Ndeye Fatou, Moustapha Niane Mouhamadou, Djoumoi Hamadi Hadji, Lamine Sarr, Badara Gueye Alioune, Daniel Sane André

机构信息

Department of Orthopedics Traumatology CHU le DANTEC Dakar, Senegal.

Department of Orthopedics Traumatology Regional Hospital of Thies, Senegal.

出版信息

Open Orthop J. 2017 May 30;11:452-459. doi: 10.2174/1874325001711010452. eCollection 2017.

Abstract

OBJECTIVE

To determine our therapeutic posture trough a comparison of functional treatment results versus immobilization in two different periods.

INTRODUCTION

For years, the treatment of recent elbow dislocations consisted of reduction and immobilization during 21 days. Given the frequency of stiffness other methods have been tried out.

METHOD

A prospective study was carried out from January 2010 to December 2014. Sixty patients averaging 28.3 years of age underwent elbow dislocation reduction. They were categorized into three separate groups. Patients in the first group had their elbow immobilized for 21 days whereas Group 2 patients were immobilized for 10 days. Group 3 patients were applied a functional treatment followed by a functional rehabilitation. Patients were evaluated according to the Mayo Clinic Elbow Performance Index and the results analyzed with statistical software (SPSS, version 18).

RESULTS

During the first month, the functional results of the patients were excellent and good in 19%, 94.7% and 90% respectively for Groups 1, 2 and 3. The pain was intense (10 on the visual analogue scale) in group 3 associated with swelling. At day 90, the results of the patients in Groups 2 and 3 were excellent in 100% of the cases versus 90% for Group 1. At 6 months, all the results were the same. We have not noted any instability, or recurrence or periarticular ossification in our patients.

CONCLUSION

The treatment of stable elbow dislocations remains orthopedic. The risk of instability and pain motivates a short 10-day immobilization period followed by early mobilization.

摘要

目的

通过比较两个不同时期功能治疗结果与固定治疗结果,确定我们的治疗方式。

引言

多年来,近期肘关节脱位的治疗方法是复位并固定21天。鉴于僵硬的发生率较高,人们尝试了其他方法。

方法

2010年1月至2014年12月进行了一项前瞻性研究。60例平均年龄28.3岁的患者接受了肘关节脱位复位。他们被分为三组。第一组患者的肘关节固定21天,而第二组患者固定10天。第三组患者接受功能治疗并随后进行功能康复。根据梅奥诊所肘关节功能指数对患者进行评估,并使用统计软件(SPSS,版本18)分析结果。

结果

在第一个月,第一、二、三组患者的功能结果分别为优和良的比例为19%、94.7%和90%。第三组患者疼痛剧烈(视觉模拟评分10分)且伴有肿胀。在第90天时,第二组和第三组患者的结果100%为优,而第一组为90%。在6个月时,所有结果相同。我们的患者未出现任何不稳定、复发或关节周围骨化情况。

结论

稳定型肘关节脱位的治疗仍为骨科治疗。不稳定和疼痛的风险促使采用短时间(10天)固定,随后尽早进行活动。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b188/5470057/9974b5b1941f/TOORTHJ-11-452_F1.jpg

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