Zheng Wei, Liu Jiazhi, Song Jialin, Fan Cunyi
Department of Orthopaedics, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, 600 Yishan Road, Shanghai, 200233, People's Republic of China.
Int Orthop. 2018 Mar;42(3):595-600. doi: 10.1007/s00264-017-3657-1. Epub 2017 Oct 7.
The purpose of this study was to compare different grades of elbow stiffness and investigate demographic, injury, and treatment factors potentially associated with the development of severe elbow stiffness.
We performed a retrospective study involving 169 patients with post-traumatic elbow stiffness between June 2014 and June 2016. Patient demographics, injury, and treatment details were reviewed. Patients were classified into three groups according to the elbow motion. Ordinal regression analyses were performed to examine the independent factors.
Patients were classified into: mild (49 patients), moderate (59 patients), and severe (61 patients) groups. Patients with severe stiffness had a significantly worse elbow functional performance. Univariate ordinal regression revealed that severe elbow stiffness was associated with high-energy injury (odds ratio [OR] 4.73), olecranon fracture (OR 1.92), fracture-dislocation (OR 2.28), and open fracture (OR 3.24). Multivariate regression showed that higher-energy injuries were associated with severe stiffness (OR 4.45, p = 0.003).
Elbow stiffness after fracture surgery often results in joint stiffness. Severe stiffness often resulted in more significant functional impairment. Our study suggested that high-energy injuries were associated with the development of severe elbow stiffness.
本研究旨在比较不同程度的肘关节僵硬，并调查可能与严重肘关节僵硬发展相关的人口统计学、损伤和治疗因素。
我们进行了一项回顾性研究，纳入了2014年6月至2016年6月期间169例创伤后肘关节僵硬患者。回顾了患者的人口统计学、损伤和治疗细节。根据肘关节活动度将患者分为三组。进行有序回归分析以检查独立因素。
患者分为：轻度（49例）、中度（59例）和重度（61例）组。重度僵硬患者的肘关节功能表现明显更差。单因素有序回归显示，严重肘关节僵硬与高能量损伤（比值比[OR]4.73）、鹰嘴骨折（OR 1.92）、骨折脱位（OR 2.28）和开放性骨折（OR 3.24）相关。多因素回归显示，更高能量的损伤与严重僵硬相关（OR 4.45，p = 0.003）。
骨折手术后的肘关节僵硬常导致关节僵硬。严重僵硬常导致更明显的功能障碍。我们的研究表明，高能量损伤与严重肘关节僵硬的发展相关。
