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切开松解联合桡骨远端固定铰链式外固定治疗肘关节僵硬

[Treatment of elbow joint stiffness by open release combined with distal radius fixation hinged external fixation].

作者信息

Liu Jiazhi, Chen Shuai, Fan Cunyi

机构信息

Taishan Medical University, Taian Shandong, 271016, P.R.China;Department of Orthopaedics, Shanghai Sixth People's Hospital of Eastern Hospital, Shanghai, 201306, P.R.China.

Department of Orthopaedics, Shanghai Sixth People's Hospital of Eastern Hospital, Shanghai, 201306, P.R.China.

出版信息

Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi. 2018 Feb 15;32(2):134-138. doi: 10.7507/1002-1892.201705102.

Abstract

OBJECTIVE

To observe the effectiveness of open release combined with distal radius fixation hinged external fixation for the treatment of elbow stiffness.

METHODS

A total of 77 patients with elbow stiffness caused by trauma were enrolled in this study between October 2014 and October 2015. The patients were divided into control group (39 cases) and observation group (38 cases) by random number table method. The patients in the observation group were treated with elbow joint opening and release combined with distal radial fixation hinged external fixation, while the control group was treated with traditional release. There was no significant difference in gender, age, disease causes, original damage diagnosis, the time from injury to operation, preoperative flexion and extension activity of elbow joint, and preoperative Mayo elbow joint function score between 2 groups ( >0.05). After operation, the function of elbow joint was evaluated by the flexion and extension activity of the elbow joint and the Mayo elbow joint function evaluation standard.

RESULTS

The incisions healed by first intention in 2 groups. In observation group, there were 1 case infection of nail tract, 2 cases ulnar nerve symptoms, 1 case elbow ossification, and 1 case moderate pain in the elbow; while in control group, there were 2 cases of infection of nail tract, 2 cases of ulnar nerve symptoms, and 3 cases moderate pain in the elbow. The patients in 2 groups were followed up 6 weeks to 12 months, with an average of 6 months. The flexion and extension activity of elbow joint and Mayo elbow joint function score at last follow-up were significantly improved when compared with preoperative ones ( <0.05); at last follow-up, the flexion and extension activity of elbow joint and Mayo elbow joint function score in observation group patients were significantly better than those in control group ( <0.05). According to the Mayo elbow function evaluation standard, the results were excellent in 27 cases, good in 10 cases, and fair in 1 case, with an excellent and good rate of 97.4% in observation group; and the results were excellent in 12 cases, good in 21 cases, fair in 4 cases, and poor in 2 cases, with an excellent and good rate of 84.6% in control group; showing no significant difference between 2 groups ( =0.108).

CONCLUSION

Open release combined with distal radius fixation hinged external fixation can significantly improve the elbow function of patients with traumatic elbow stiffness, its recovery of elbow function was superior to the traditional release.

摘要

目的

观察切开松解联合桡骨远端固定铰链式外固定治疗肘关节僵硬的疗效。

方法

选取2014年10月至2015年10月收治的77例创伤性肘关节僵硬患者,采用随机数字表法分为对照组(39例)和观察组(38例)。观察组采用肘关节切开松解联合桡骨远端固定铰链式外固定治疗,对照组采用传统松解术治疗。两组患者性别、年龄、病因、原始损伤诊断、受伤至手术时间、术前肘关节屈伸活动度及术前Mayo肘关节功能评分比较,差异均无统计学意义(P>0.05)。术后采用肘关节屈伸活动度及Mayo肘关节功能评价标准对肘关节功能进行评价。

结果

两组切口均一期愈合。观察组发生钉道感染1例,尺神经症状2例,肘关节骨化1例,肘关节中度疼痛1例;对照组发生钉道感染2例,尺神经症状2例,肘关节中度疼痛3例。两组患者均随访6周~12个月,平均6个月。末次随访时,两组患者肘关节屈伸活动度及Mayo肘关节功能评分均较术前明显改善(P<0.05);末次随访时,观察组患者肘关节屈伸活动度及Mayo肘关节功能评分明显优于对照组(P<0.05)。根据Mayo肘关节功能评价标准,观察组优27例,良10例,可1例,优良率为97.4%;对照组优12例,良21例,可4例,差2例,优良率为84.6%;两组比较差异无统计学意义(P=0.108)。

结论

切开松解联合桡骨远端固定铰链式外固定能显著改善创伤性肘关节僵硬患者的肘关节功能,其肘关节功能恢复优于传统松解术。

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Posttraumatic stiff elbow.创伤后肘关节僵硬
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