Wu Chang-Qing, Hua Ying, Liu Yong-Zhan
Department of Orthopaedics and Traumatology, No.951 Hospital, Korla 841000, Xinjiang Uygur Zizhiqu, China.
Zhongguo Gu Shang. 2023 Jul 25;36(7):614-8. doi: 10.12200/j.issn.1003-0034.2023.07.004.
To investigate the risk factors of elbow stiffness after open reduction and internal fixation of intercondylar fracture of humerus.
From March 2015 to February 2019, 120 patients with humeral intercondylar fractures were treated with open fixation including 59 males and 61 females, aged from 25 to 77 years with an average of(53.5±3.2) years. According to the occurrence of elbow stiffness after operation, 120 patients were divided into stiffness group(37 cases) and control group(83 cases). The related factors of elbow stiffness were analyzed by single factor analysis, and the risk of elbow stiffness after internal fixation of humeral intercondylar fracture was analyzed by logistic regression factor.
There were 37 cases of elbow stiffness(stiff group), and 83 cases had no elbow stiffness(control group). The incidence of joint stiffness was 30.83%. There were significant differences between the stiffness group and the control group in age, injury energy, fracture to operation time, AO classification of fracture, open injury and postoperative premature or hyperactivity. Multivariate logistic regression analysis showed that age>50 years old, high energy injury, AO classification of fracture, open fracture and postoperative premature or hyperactivity were risk factors for elbow stiffness after internal fixation of humeral intercondylar fracture. The postoperative mobility and Mayo elbow performance score(MEPS) scores of the postoperative stiffness group were lower than those of the non-stiffness group with statistical significance(<0.05). There were no significant differences in postoperative mobility and MEPS scores between flexion stiffness and rotation stiffness after humeral intercondylar fracture(>0.05).
In view of the risk factors of elbow stiffness after internal fixation of humeral intercondylar fracture, reasonable operation plan and rehabilitation strategy should be formulated before operation to minimize the incidence of elbow stiffness.
探讨肱骨髁间骨折切开复位内固定术后肘关节僵硬的危险因素。
选取2015年3月至2019年2月采用切开固定治疗的120例肱骨髁间骨折患者,其中男59例,女61例,年龄25~77岁,平均(53.5±3.2)岁。根据术后肘关节僵硬的发生情况,将120例患者分为僵硬组(37例)和对照组(83例)。采用单因素分析肘关节僵硬的相关因素,采用logistic回归分析肱骨髁间骨折内固定术后肘关节僵硬的风险因素。
发生肘关节僵硬37例(僵硬组),未发生肘关节僵硬83例(对照组),关节僵硬发生率为30.83%。僵硬组与对照组在年龄、受伤能量、骨折至手术时间、骨折AO分型、开放性损伤及术后过早活动或过度活动方面比较,差异有统计学意义。多因素logistic回归分析显示,年龄>50岁、高能量损伤、骨折AO分型、开放性骨折及术后过早活动或过度活动是肱骨髁间骨折内固定术后肘关节僵硬的危险因素。术后僵硬组的术后活动度及Mayo肘关节功能评分(MEPS)均低于非僵硬组,差异有统计学意义(<0.05)。肱骨髁间骨折后屈曲僵硬与旋转僵硬的术后活动度及MEPS评分比较,差异无统计学意义(>0.05)。
针对肱骨髁间骨折内固定术后肘关节僵硬的危险因素,术前应制定合理的手术方案及康复策略,以降低肘关节僵硬的发生率。