张力性支具结合开放松解术治疗肘关节僵硬的初步疗效分析  

Preliminary efficacy analysis of tension brace combined with open arthrolysis in the treatment of elbow ankylosis

作　　者：熊晨 张堃[2] 何晓 杨佳瑞 何昌军 黄伟 朱养均[2] 衡立松[2] Xiong Chen;Zhang Kun;He Xiao;Yang Jiarui;He Changjun;Huang Wei;Zhu Yangjun;Heng Lisong(Yan'an University,Yan'an 716000,China;Department of Orthopaedic and Trauma,Honghui Hospital,Xi'an Jiaotong University,Xi'an 710054,China)

机构地区：[1]延安大学医学院(外科学专业),716000 [2]西安交通大学医学院附属红会医院创伤骨科,710054

出　　处：《中华肩肘外科电子杂志》2021年第3期257-262,共6页Chinese Journal of Shoulder and Elbow(Electronic Edition)

基　　金：陕西省重点研发计划项目(2017SF-197);西安市科技计划项目(20YXYJ004)。

摘　　要：目的探讨张力性支具结合开放性肘关节松解术治疗肘关节僵硬的初步疗效。方法回顾性分析我院采用开放性肘关节松解术治疗的40例肘关节僵硬患者资料。单纯采用开放性肘关节松解术为对照组(21例),采用张力性支具结合开放肘关节松解术为观察组(19例)。比较两组患者末次随访时肘关节屈伸、旋转活动度和Mayo肘关节功能评分,并评定疗效。结果所有患者术后均获得随访,随访时间12~28个月,平均18.9个月。对照组与观察组相比,术后末次随访时肘关节旋转活动度[(142.14±34.91)°VS(136.32±42.75)°,t=0.562,P=0.910]差异无统计学意义;肘关节屈伸活动度[(95.71±10.87)°VS(107.47±14.13)°,t=2.966,P=0.005]和Mayo肘关节功能评分[(72.62±6.05)分VS(80.79±9.61)分,t=1.456,P=0.029]观察组显著高于对照组,差异均有统计学意义。结论张力性支具结合开放性肘关节松解术可以改善肘关节的屈伸活动度和肘关节功能,疗效满意。Background When a fracture occurs around the elbow,it can easily lead to joint stiffness if it is not properly treated and rehabilitated.The incidence of post-traumatic elbow ankylosis is 3%to 20%,which seriously affects people’s daily life.After the single release,if the elbow joint rehabilitation exercise is not appropriate,the joint stiffness may reoccur.In order to avoid the recurrence of stiffness,orthopaedic surgeons take a variety of measures to carry out rehabilitation exercise and improve the elbow function.Objective To investigate the preliminary efficacy of tension brace combined with open elbow arthrolysis in the treatment of elbow ankylosis.Methods The data of 40 patients with elbow ankylosis treated with open elbow lysis in our hospital were analyzed retrospectively.Open elbow joint arthrolysis was used in control group(n=21)and tension brace combined with open elbow joint release in observation group(n=19).The ranges of elbow flexion,extension and rotation and Mayo elbow function score were compared between the two groups during the last follow-up,and the curative effect was evaluated.Results All patients were followed up for 12 to 28 months with an average of 18.9 months.There was no statistical difference in the range of elbow joint rotation between the control group and the observation group in the last follow-up[(142.14±34.91)°vs(136.32±42.75)°,t=0.562,P=0.910],but there was significant difference in the ranges of flexion and extension[(95.71±10.87)°vs(107.47±14.13)°,t=2.966,P=0.005]and Mayo elbow function score[(72.62±6.05)score vs(80.79±9.61)score,t=1.456,P=0.029].The ranges of elbow flexion and extension and Mayo elbow function score of the observation group were significantly higher than those of the control group in the last follow-up.Conclusion Tension brace combined with open elbow joint arthrolysis can improve the ranges of elbow flexion and extension of elbow joint and improve the function of the elbow joint.

关 键 词：肘关节 僵硬 松解术 治疗结果 

分 类 号：R687.3[医药卫生—骨科学]