Zhang Dafang, Nazarian Ara, Rodriguez Edward K
Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC), Boston, MA, USA.
Harvard Medical School, Boston, MA, USA.
Shoulder Elbow. 2020 Feb;12(1):38-45. doi: 10.1177/1758573218793903. Epub 2018 Aug 8.
Post-traumatic elbow stiffness is a major cause of functional impairment after elbow trauma. A stiff elbow limits patients' ability to position their hand in space for optimal use of their upper extremities, and as such, is a frequent indication for reoperation. This article reviews current concepts on the pathogenesis of post-traumatic elbow stiffness. Current nonoperative treatment options include therapy, bracing, and manipulation under anesthesia, while operative treatment options include arthroscopic and open arthrolysis. The pros and cons of various treatment options are discussed, with a focus on the evidence supporting their use, the expected functional gains, and associated complications. Future directions in post-traumatic elbow stiffness are highlighted.
创伤后肘关节僵硬是肘部创伤后功能障碍的主要原因。僵硬的肘关节限制了患者将手放置在空间中以最佳利用上肢的能力,因此,它是再次手术的常见指征。本文综述了创伤后肘关节僵硬发病机制的当前概念。目前的非手术治疗选择包括理疗、支具固定和麻醉下手法松解,而手术治疗选择包括关节镜下和切开松解术。讨论了各种治疗选择的利弊,重点是支持其使用的证据、预期的功能改善以及相关并发症。强调了创伤后肘关节僵硬的未来发展方向。