Timmerman L A, Andrews J R
American Sports Medicine Institute, Birmingham, Alabama 35205.
Am J Sports Med. 1994 Mar-Apr;22(2):230-5. doi: 10.1177/036354659402200213.
Nineteen consecutive cases of posttraumatic arthrofibrosis of the elbow secondary to a fracture or fracture-dislocation and treated with arthroscopic debridement and manipulation were retrospectively reviewed. All of the patients had pain and stiffness in their elbows, and all had failed a conservative therapy program. All 19 patients were followed postoperatively for an average of 29 months (range, 12 to 51). One hundred-point scoring systems were used to evaluate subjective (pain, swelling, locking, and activities) and objective (range of motion) results. The average preoperative subjective score of 39 improved to 91 postoperatively (P = 0.0001); the objective score improved from 46 preoperatively to 81 postoperatively (P = 0.0001). Extension improved from a mean of 29 degrees to 11 degrees; flexion improved from an average of 123 degrees to 134 degrees. Fourteen patients had limitations in their sports activity preoperatively; 11 were able to return to their preinjury levels of activity after surgery. This study demonstrated good-to-excellent overall results in 79% of the patients treated with arthroscopic debridement for posttraumatic elbow arthrofibrosis. Although complete return of preinjury motion was not obtained, each patient showed a significant improvement in motion and subjective symptoms.
回顾性分析了19例因骨折或骨折脱位继发创伤后肘关节纤维性关节强直并接受关节镜下清创及手法治疗的连续病例。所有患者均有肘部疼痛和僵硬，且均对保守治疗方案无效。19例患者术后平均随访29个月（范围12至51个月）。采用百分制评分系统评估主观（疼痛、肿胀、绞锁及活动情况）和客观（活动范围）结果。术前主观平均评分39分，术后提高至91分（P = 0.0001）；客观评分从术前46分提高至术后81分（P = 0.0001）。伸直从平均29°改善至11°；屈曲从平均123°改善至134°。14例患者术前体育活动受限；11例术后能够恢复到伤前活动水平。本研究表明，79%接受关节镜下清创治疗创伤后肘关节纤维性关节强直的患者取得了良好至优异的总体效果。尽管未完全恢复到伤前活动度，但每位患者的活动度和主观症状均有显著改善。
