关节镜松解术治疗肘关节僵硬的临床研究  

Clinical Study on Arthroscopic Treatment of Elbow Stiffness

作　　者：王立志 李宇 杨洪彬 Wang lizhi;Li yu;Yang hongbin(Department Bone and Joint Surgery,Southwest Medical University Affiliated Hospital,Luzhou646000,China)

机构地区：[1]西南医科大学附属医院骨与关节外科,四川泸州646000

出　　处：《实用骨科杂志》2018年第12期1065-1068,共4页Journal of Practical Orthopaedics

摘　　要：目的探讨关节镜松解术治疗关节内因素引起的肘关节僵硬的临床疗效。方法回顾性分析研究自2013年5月至2016年5月,西南医科大学附属医院骨与关节外科应用肘关节镜松解术治疗关节内因素引起的肘关节僵硬21例,其中男13例,女8例;年龄17～64岁,平均(41.8±7.1)岁。关节镜下松解挛缩的关节囊,清理增生的滑膜,取出游离体以及打磨清理增生骨赘,伴有尺神经卡压综合征的患者予以尺神经松解前置。观察对比患者手术前后关节活动度(range of motion,ROM)变化以及使用Mayo评分标准评价患肘功能康复情况。结果本组手术均成功,随访9～26个月,平均(15.4±10.7)个月。术前肘关节平均最大屈伸活动度为(63.7±22.3)°,术后改善为(106.5±32.8)°。术后根据Mayo肘关节功能系统评分,术后较术前提高了(28.5±6.2)分,优8例,良10例,一般3例。术后均无神经、血管损伤,未出现感染、异位骨化、血栓等并发症,术后疼痛及关节活动度改善明显。结论关节镜松解术治疗关节内因素引起的肘关节僵硬,可有效改善肘关节活动度及肘关节功能,是一种安全、有效的治疗手段,疗效满意。Objective To investigate the clinical results of arthroscopic surgery on the stiffness of the elbow joint caused by intrinsic factors.Methods From May 2013 to May 2016,21 cases of elbow stiffness caused by intrinsic factors were treated by arthroscopic surgery in the Affiliated Hospital of Southwest Medical University,including 13 male and 8 femal.The patients were 17 to 64 years old,with an average age of(41.8±7.1)years,and a retrospective analysis was carried out.Articular capsule contracture was released under arthroscopy,synovium hyperplasia was cleared,free body was removed,and osteophytes hyperplasia was cleaned by grinding.Patients with ulnar nerve compression syndrome were pretreated with ulnar nerve release.The range of motion(ROM)before and after surgery was observed and compared,and the rehabilitation of elbow function was evaluated by Mayo scoring system.Results All surgeries were successful and followed up for 9 to 26 months,with an average of(15.4±10.7)months.The average maximum flexion and extension range of elbow joint was(63.7±22.3)degree before operation and(106.5±32.8)degree after operation.After the operation,the score of Mayo elbow joint functional system was improved(28.5±6.2),eight patients got an excellent result,10 good and 3 fair.There were no nerve or vascular injury,no infection,ectopic ossification,thrombosis and other complications,and the postoperative pain and joint activity were significantly improved.Conclusion Arthroscopic surgery of the elbow joint caused by intrinsic factors can effectively improve the elbow joint activity and the function of the elbow joint.It is a safe and effective treatment,and the curative effect is satisfactory.

关 键 词：关节镜 肘关节 关节僵硬 

分 类 号：R684[医药卫生—骨科学]