Søjbjerg J O
Department of Orthopedics, University Hospital of Aarhus, Denmark.
Acta Orthop Scand. 1996 Dec;67(6):626-31. doi: 10.3109/17453679608997771.
Contracture of the elbow is a common complication of fractures, dislocations, burns, etc., around the elbow. The stiff or contracted elbow is defined as an elbow with a reduction in extension greater than 30 degrees, and/or a flexion less than 120 degrees. Although supination and pronation are often reduced as well, this will not be considered further as contracture of the elbow is not related to forearm rotation. Stiffness of the elbow impairs hand function, because this is highly dependent on elbow extension and flexion and forearm rotation. A 50% reduction of elbow motion can reduce the upper extremity function by almost 80%. Surgery of the posttraumatic stiff elbow is a challenging and demanding procedure. During recent years a more aggressive approach to the treatment of chronic contractures around the elbow joint in combination with more specific surgical techniques and an advanced postoperative rehabilitation have improved the final outcome. The purpose of my article is to define a reasonable and specific approach for the clinician in the surgical management of the posttraumatic stiff elbow, based on a review of the literature and my personal experience.
肘关节挛缩是肘部周围骨折、脱位、烧伤等常见的并发症。僵硬或挛缩的肘关节定义为伸展减少超过30度和/或屈曲小于120度的肘关节。虽然旋前和旋后通常也会受限，但由于肘关节挛缩与前臂旋转无关，故不再进一步考虑。肘关节僵硬会损害手部功能，因为这高度依赖于肘关节的伸展和屈曲以及前臂旋转。肘关节活动度降低50%可使上肢功能降低近80%。创伤后僵硬肘关节的手术是一项具有挑战性且要求很高的操作。近年来，对于肘关节周围慢性挛缩采用更积极的治疗方法，结合更具体的手术技术和先进的术后康复措施，改善了最终治疗效果。我撰写本文的目的是基于文献回顾和个人经验，为临床医生在创伤后僵硬肘关节的手术治疗中确定一种合理且具体的方法。
