动力位CT重建技术在退变性肘关节僵硬个体化松解手术中的应用  

Application of Dynamic Position CT Reconstruction Technology for Individualized Arthrolysis in Degenerative Stiff Elbow

作　　者：李海滨[1] 王铭[1] 代娟[1] 邓广明 付洪睿 厚艳芳 马艳 刘会欣[1] Li Haibin;Wang Ming;Dai Juan(Department of Orthopedics, People’s Hospital of Qingxian, Qingxian 062650, China)

机构地区：[1]河北省青县人民医院骨关节科,青县062650

出　　处：《中国微创外科杂志》2022年第2期126-130,共5页Chinese Journal of Minimally Invasive Surgery

摘　　要：目的探讨动力位CT重建技术在退变性肘关节僵硬个体化松解手术中的应用效果。方法2018年8月~2020年8月我科收治退变性肘关节僵硬31例,术前患肘行动力位CT重建,制定个体化关节清理方案并实施手术,术后指导康复锻炼。采用Mayo肘关节功能评分(Mayo Elbow Performance Score,MEPS)、视觉模拟评分(Visual Analogue Scale,VAS)进行治疗效果评价。结果31例随访6~36个月,平均15.3月。MEPS评分术前(65.7±15.5)分,显著低于术后6个月(90.7±9.8)分(t=-11.241,P=0.000)。肘关节疼痛VAS评分中位数由术前3分(1~6)分降低到术后6个月1分(0~2)分(Z=-5.091,P=0.000)。肘关节主动活动角度改善显著:屈肘由术前97.8°±14.3°增加到术后122.3°±7.4°(t=-12.453,P=0.000),伸肘由术前24.5°±10.3°降低到术后7.4°±4.6°(t=13.746,P=0.000);屈伸活动弧度由术前73.6°±18.1°增加到114.8°±8.6°(t=-17.372,P=0.000)。结论退变性肘关节僵硬松解手术中应用动力位CT重建降低手术难度,减少手术风险。Objective To evaluate the application effect of dynamic position CT reconstruction technology for individualized arthrolysis in degenerative stiff elbow.Methods A total of 31 patients with degenerative stiff elbow were admitted to our department from August 2018 to August 2020.The dynamic position CT reconstruction was applied on affected elbow joint before operation.The individualized arthrolysis protocol was developed for performing surgery and instructing rehabilitation exercises after surgery.The Mayo elbow performance score(MEPS)and the visual analogue scale(VAS)were used to evaluate therapeutic effects.Results The 31 patients were followed up for 6-36 months(mean,15.3 months).The preoperative MEPS score was(65.7±15.5)points,which was significantly lower than the postoperative[(90.7±9.8)points,t=-11.241,P=0.000].The Median VAS score of elbow pain decreased from 3 points preoperatively to 1 points postoperatively(Z=-5.091,P=0.000).Significant improvement was achieved in elbow active motion:elbow flexion increased from 97.8°±14.3°preoperatively to 122.3°±7.4°postoperatively(t=-12.453,P=0.000),and elbow extension decreased from 24.5°±10.3°preoperatively to 7.4°±4.6°postoperatively(t=13.746,P=0.000).The arc of flexion and extension increased from 73.6°±18.1°preoperatively to 114.8°±8.6°(t=-17.372,P=0.000).Conclusion The application of dynamic position CT reconstruction technology in degenerative stiff elbow arthrolysis can reduce the difficulty of surgery and reduce the risk of surgery.

关 键 词：动力位CT重建技术 关节松解 肘关节僵硬 

分 类 号：R68[医药卫生—骨科学]