广泛松解联合铰链式外支架固定治疗复杂肘关节创伤术后僵硬的疗效分析  

Therapeutic effect analysis of extensive arthrolysis combined with hinged external fixation in the treatment of postoperative elbow joint stiffness after complex trauma surgery

作　　者：吴加东[1] 卞化 成兴海 沈孝天 王超[1] 孙焕建[1] Wu Jiadong, Bian Hua, Cheng Xinghai, Shen Xiaotian, Wang Chao, Sun Huanjian(Department of Orthopaedics, The Affiliated Yancheng Hospital of Southeast University Medical College, Yancheng 224005, China)

机构地区：[1]东南大学医学院附属盐城医院(盐城市第三人民医院)骨科,224005

出　　处：《中华肩肘外科电子杂志》2018年第2期115-119,共5页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：盐城市医学科技发展计划项目(YK2017098)

摘　　要：目的探讨广泛松解联合铰链式外支架固定治疗复杂肘关节创伤术后僵硬的疗效。方法 2012年1月至2014年12月盐城市第三人民医院共手术治疗复杂肘关节创伤术后僵硬患者13例,广泛松解联合铰链式外支架固定,术后服用塞来昔布,镇痛下康复训练。按照Broberg和Morrey肘关节功能评分进行疗效评定。结果术后随访时间为18~24个月,平均20.8个月。术前肘关节平均伸直角度为(31.5±2.7)°,平均屈曲角度为(93.0±10.1)°,活动范围为(61.5±12.4)°。术后肘关节平均伸直角度为(10.5±2.4)°,平均屈曲角度为(117.5±4.2)°,活动范围为(107.0±6.1)°(P<0.05)。按照Broberg和Morrey肘关节功能评分进行疗效评定:优2例,良8例,一般3例,优良率76.9%。结论治疗肘关节僵硬不能"生畏",需彻底松解,正规康复,以期功能良好恢复。Background The elbow joint is a very harmonious and stable joint on human body, but it is also very vulnerable. With the development of transportation and industry, complex elbow joint injuries are constantly emerging. As clinicians are focusing more on all kinds of operative research, postoperative functional deficiency and stiffness of different levels come as the problems that are awaited to be solved. In recent years, posttraumatic elbow joint stiffness has been paid with more attention. Although conservative and surgical methods are numerous, the curative effects are inconsistent. Therefore, the selection of appropriate treatment method is the prerequisite for good recovery of elbow function. Methods？（1） General information. From January 2012 to December 2014, 13 patients （8 males and 5 females） with posttraumatic elbow joint stiffness were treated in our hospital with extensive arthrolysis and hinged external fixator. The age ranged from 35 to 77 years with an average of 40.3 years. Causes of injury： 7 cases of traffic accident, 4 cases of fall damage and 2 cases of high fall. Types of elbow injury： 3 cases of comminuted distal humeral fracture, 5 cases of terrible triad of elbow, 1 case of radial head fracture combined with ulna coronoid process fracture, 1 case of radial head fracture combined with olecranal fracture, 1 cases of radial head fracture combined with capitellum fracture, 2 cases of trans olecranon fracture-dislocation （1 case combined with lumbar transverse process fracture, and 1 case combined with rib fracture）. All the fractures were closed, and the initial injuries were performed with internal fixation. According to Morrey classification （extreme severity for≤ 30°, severity for 31-60°, moderation for 61-90° and mildness for 〉90°）, there were 8 cases of moderate, 4 cases of severe and 1 case of extremely severe. The mean preoperative extension angle, mean flexion angle and mean range of motion were （31.5±2.7）°, （93.0±10.1）° and （61.5±12.4）° r

关 键 词：松解 铰链式外支架 肘关节僵硬 塞来昔布 康复 

分 类 号：R687.4[医药卫生—骨科学]