Urbaniak J R, Hansen P E, Beissinger S F, Aitken M S
J Bone Joint Surg Am. 1985 Oct;67(8):1160-4.
Despite prolonged conservative therapy, including splinting, bracing, and supervised exercise programs, significant flexion contracture of the elbow after local trauma may remain both a functional and a cosmetic impairment. We studied the cases of fifteen patients who underwent a relatively limited surgical procedure consisting of anterior capsulotomy of the elbow without tenotomy of the biceps tendon or myotomy of the brachialis muscle. The mean preoperative flexion deformity of 48 degrees was reduced to a mean postoperative deformity of 19 degrees (a 61 per cent improvement). Two groups of patients were identified. Eleven patients who did not have significant preoperative evidence of intra-articular degenerative (post-traumatic) changes in the joint achieved a 65 per cent improvement in extension, with one patient having continued pain with vigorous activity. Four patients who had significant preoperative post-traumatic arthrosis achieved a 50 per cent improvement in extension; however, three of these four patients continued to have significant pain. Limited anterior capsulotomy is a safe and effective means of decreasing post-traumatic flexion contracture of the elbow in properly selected patients. Better overall results are obtained in elbows without significant post-traumatic arthrosis.
尽管进行了长期的保守治疗，包括夹板固定、支具治疗和有监督的锻炼计划，但局部创伤后肘部出现的明显屈曲挛缩可能仍然会造成功能和外观上的损害。我们研究了15例患者的病例，这些患者接受了一种相对有限的外科手术，即肘部前方关节囊切开术，不进行肱二头肌腱切断术或肱肌肌切开术。术前平均屈曲畸形为48度，术后平均畸形减少至19度（改善了61%）。确定了两组患者。11例术前关节内无明显退行性（创伤后）改变证据的患者，伸直改善了65%，其中1例患者在剧烈活动时仍持续疼痛。4例术前有明显创伤后关节炎的患者，伸直改善了50%；然而，这4例患者中有3例仍有明显疼痛。对于经过适当选择的患者，有限的前方关节囊切开术是减少创伤后肘部屈曲挛缩的一种安全有效的方法。在没有明显创伤后关节炎的肘部，总体效果更好。
