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关节松解术治疗创伤后膝关节伸肌僵硬(作者译)

[Arthrolysis in the treatment of post-traumatic extensor rigidity of the knee (author's transl)].

作者信息

Blauth W, Hepp W R

出版信息

Z Orthop Ihre Grenzgeb. 1978;116(2):220-3.

PMID:654462
Abstract

Extensor rigidity of the knee may be due to a wide variety of causes and is certainly quite often a sequela of an injury. Rigidity is caused by damage to tissue distant or proximal to the knee joint, in the joint itself, or simultaneously at several locations. In many cases considerable improvement can be achieved by arthrolysis. However, this requires detailed knowledge of the involved and expected pathologic changes. Besides detailed clinical and x-ray examination via arthrography it is particularly important to select and prepare the patients properly. Knee arthrolysis can never be based on only one surgical procedure. The authors differentiate between covered and open loosening of the stiffened joint besides intraarticular and extraarticular arthrolysis, and a combined intraarticular and extraarticular procedure. Postoperative followup treatment is at least just as important as the surgical procedure itself. Complications can be largely avoided via subtile technique and sufficient experience. The authors report on 16 followup examinations effected during the past four subsequent to arthrolyses of the knee. On the average there was an improvement in flexibility and stretch-ability by 70 degrees, or a relative flexibility increase by 80%. No serious complications were seen. Arthrolysis of the knee is recommended as a well-tried and highly successful surgical procedure.

摘要

膝关节伸肌僵硬可能由多种原因引起,而且常常是损伤的后遗症。僵硬是由膝关节远处或近端的组织损伤、关节本身的损伤或多个部位同时受损所致。在许多情况下,关节松解术可取得显著改善。然而,这需要详细了解所涉及的和预期的病理变化。除了通过关节造影进行详细的临床和X线检查外,正确选择和准备患者尤为重要。膝关节松解术绝不能仅基于一种手术方法。作者除了区分关节内和关节外松解术以及联合关节内和关节外手术外,还区分了僵硬关节的覆盖式和开放式松解。术后随访治疗至少与手术本身同样重要。通过精湛的技术和丰富的经验,并发症在很大程度上是可以避免的。作者报告了过去四次膝关节松解术后进行的16次随访检查。平均而言,灵活性和伸展能力提高了70度,或相对灵活性提高了80%。未发现严重并发症。膝关节松解术被推荐为一种经过充分试验且非常成功的手术方法。

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