Andelman Steven M, Walsh Amanda L, Sochol Kristen M, Rubenstein William M, Hausman Michael R
Department of Orthopaedic Surgery, The Mount Sinai Icahn School of Medicine, New York, NY.
J Pediatr Orthop. 2018 Oct;38(9):e507-e513. doi: 10.1097/BPO.0000000000001216.
Elbow contracture is a sequelae of elbow trauma in pediatric patients. Arthroscopic contracture release has been shown to provide equivalent results to open contracture release with less associated morbidity and complications in the adult population. However, open contracture release is still commonly utilized in pediatric patients. The goal of this study is to determine the clinical results and safety profile of arthroscopic elbow contracture release in the pediatric population.
A retrospective review of all patients 18 years of age and younger who underwent arthroscopic elbow contracture release was performed. Demographic statistics, indication for surgery, preoperative and postoperative flexion-extension and pronation-supination range of motion, and all complications were recorded and analyzed.
Twenty-five patients were identified as having undergone 29 arthroscopic elbow contracture releases. The most common index injury was elbow contracture after radial head fracture. The flexion-extension arc of motion improved from 93.0±39.9 degrees to 128.0±19.2 degrees for a total improvement of 35.2 degrees (P=0.0002), whereas the pronation-supination arc of motion improved from 141.0±58.6 degrees to 153±49.3 degrees for a total improvement of 12.2 degrees (P=0.097). There were 7 total complications.
Arthroscopic elbow contracture release allows for restoration of range of motion with an acceptable safety profile and can be considered as a less invasive alternative to open contracture release in the pediatric population.
Level IV.
肘关节挛缩是儿科患者肘部创伤的后遗症。在成人中，关节镜下挛缩松解术已被证明与开放性挛缩松解术效果相当，且相关发病率和并发症更少。然而，开放性挛缩松解术在儿科患者中仍被广泛应用。本研究的目的是确定关节镜下肘关节挛缩松解术在儿科患者中的临床效果和安全性。
对所有18岁及以下接受关节镜下肘关节挛缩松解术的患者进行回顾性研究。记录并分析人口统计学数据、手术指征、术前和术后屈伸及旋前旋后活动范围以及所有并发症。
确定25例患者接受了29次关节镜下肘关节挛缩松解术。最常见的损伤是桡骨头骨折后肘关节挛缩。屈伸活动弧度从93.0±39.9度提高到128.0±19.2度，总共提高了35.2度（P=0.0002），而旋前旋后活动弧度从141.0±58.6度提高到153±49.3度，总共提高了12.2度（P=0.097）。总共有7例并发症。
关节镜下肘关节挛缩松解术可恢复活动范围，安全性可接受，可被视为儿科患者开放性挛缩松解术的一种侵入性较小的替代方法。
四级。
