Yang Changhao, Dong Jinye, Liu Fanxiao, Zhao Xuehui, Xu Jiajun, Yu Zhanchuan, Lu Shun, Xu Weicheng, Li Lianxin, Dong Jinlei
Department of Orthopedics Surgery, Shandong Provincial Hospital affiliated to Shandong First Medical University, 324 Jing Wu Road, Jinan, 250021, China.
Department of Ultrasound, Weifang People's Hospital, No. 151 of Guangwen Street, Weifang, Shandong, 261041, China.
BMC Musculoskelet Disord. 2024 Dec 18;25(1):1016. doi: 10.1186/s12891-024-08167-6.
The present study aimed to compare the functional outcomes of hinged external fixators and non-external fixation in open elbow arthrolysis (OEA) for post-traumatic elbow stiffness (PTES) and to evaluate their applicability and limitations in patients with posttraumatic elbow stiffness.
The clinical data of patients with PTES treated with OEA at our hospital between March 2015 and June 2022 were retrospectively analyzed. The assessed variables were the operation time, intraoperative blood loss volume, duration of hospitalization, and treatment costs. The elbow range of motion (ROM), Mayo Elbow Performance Score (MEPS), shortened disabilities of the arm, shoulder and hand questionnaire (Q-DASH) score, Oxford Elbow score (OES), Broberg and Morrey score (BMS), visual analog scale (VAS) for pain, and complications such as pin tract infection and heterotopic ossification were compared between patients with and without hinge external fixation. We also compared the baseline characteristics and functional outcomes of patients with and without hinge external fixation.
A total of 156 patients (48 patients with hinged external fixators and 108 patients without external fixators) diagnosed with PTES were included in this study. The mean follow-up was 15.8 ± 3.6 months. Compared with patients without external fixators, those with external fixators showed significantly greater improvements in elbow flexion and extension ROM (59.6° ± 26.1° vs. 46.2° ± 26.2°, p = 0.004) but had a significantly longer duration of hospitalization (p < 0.001), significantly longer operation time (p < 0.001), significantly higher treatment costs (p < 0.001), and significantly greater intraoperative blood loss volume (p < 0.001). There were no significant differences between the two groups in terms of improvement in elbow rotation ROM, MEPS score, VAS score for pain, OES score, Q-DASH score, BMS score, or incidence of complications.
The use of a hinged external fixator in open arthrolysis for posttraumatic elbow stiffness may result in short-term improvements in flexion-extension range of motion but is accompanied by increased blood loss, longer operative time, extended hospitalization, and higher costs. Further studies are needed to confirm these findings.
Not applicable.
本研究旨在比较创伤后肘关节僵硬（PTES）的开放性肘关节松解术（OEA）中使用铰链式外固定器与不使用外固定器的功能结局，并评估其在创伤后肘关节僵硬患者中的适用性和局限性。
回顾性分析2015年3月至2022年6月在我院接受OEA治疗的PTES患者的临床资料。评估的变量包括手术时间、术中失血量、住院时间和治疗费用。比较使用和未使用铰链式外固定器的患者之间的肘关节活动范围（ROM）、梅奥肘关节功能评分（MEPS）、手臂、肩部和手部简化功能障碍问卷（Q-DASH）评分、牛津肘关节评分（OES）、布罗伯格和莫里评分（BMS）、疼痛视觉模拟量表（VAS）以及诸如针道感染和异位骨化等并发症。我们还比较了使用和未使用铰链式外固定器的患者的基线特征和功能结局。
本研究共纳入156例诊断为PTES的患者（48例使用铰链式外固定器，108例未使用外固定器）。平均随访时间为15.8±3.6个月。与未使用外固定器的患者相比，使用外固定器的患者在肘关节屈伸ROM方面有显著更大的改善（59.6°±26.1°对46.2°±26.2°，p = 0.004），但住院时间显著更长（p < 0.001），手术时间显著更长（p < 0.001），治疗费用显著更高（p < 0.001），术中失血量显著更大（p < 0.001）。两组在肘关节旋转ROM改善、MEPS评分、疼痛VAS评分、OES评分、Q-DASH评分、BMS评分或并发症发生率方面无显著差异。
在创伤后肘关节僵硬的开放性松解术中使用铰链式外固定器可能会导致屈伸活动范围在短期内得到改善，但会伴有失血量增加、手术时间延长、住院时间延长和费用增加。需要进一步研究来证实这些发现。
不适用。
