关节镜下松解非创伤性肘关节僵硬手术的疗效分析  

Analysis of the efficacy of arthroscopic surgery for non-traumatic elbow stiffness

作　　者：肖军杰 齐江明 齐伟亚 朱辉 郑大伟 孔维康 吴艳萍 胡俊生 Xiao Junjie;Qi Jiangming;Qi Weiya;Zhu Hui;Zheng Dawei;Kong Weikang;Wu Yanping;Hu Junsheng(Department of Orthopaedic,Xuzhou Charity Hospital,Xuzhou 221000,China)

机构地区：[1]徐州仁慈医院骨科,221000 [2]郑州市骨科医院骨科,450000

出　　处：《骨科临床与研究杂志》2024年第3期189-192,共4页Journal Of Clinical Orthopedics And Research

摘　　要：目的探讨关节镜下松解非创伤性肘关节僵硬手术治疗的效果。方法回顾性分析2020年7月至2023年1月徐州仁慈医院骨科采用关节镜松解治疗的50例非创伤性肘关节僵硬患者资料,评价临床及影像结果。结果所有患者均顺利完成手术,切口48例一期愈合。2例出现关节液外渗,经换药处理均2周后愈合。1例出现肱静脉损伤;2例出现尺神经感觉支配区麻木,经治疗后均3个月恢复。50例均无切口感染。随访(15.0±4.7)个月。末次随访时VAS评分显著下降[(0.6±1.3)分比(0.2±0.2)分,P=0.002];而MEPS评分、肘关节屈伸ROM显著增加[(66.7±4.4)分比(87.5±6.8)分,P<0.001]。末次随访时1例出现异位骨化。结论关节镜下肘关节松解术治疗非外伤性肘关节僵硬可获得满意临床疗效,但肘关节镜技术学习曲线较长、具有一定难度,需注意手术操作细节,尽可能减少并发症。Objective To explore the effect of arthroscopic release for non-traumatic elbow stiffness surgical treatment.Methods The data of 50 patients with non-traumatic elbow stiffness treated with arthroscopic release in Department of Orthopaedic,Xuzhou Charity Hospital,were retrospectively analyzed from July 2020 to January 2023.Results All patients successfully completed the surgery,the incision healed in one stage in 48 cases.Joint fluid extravasation occurred in 2 cases,which healed in 2 weeks after dressing change.Brachial vein injury occurred in 1 case,and numbness in the sensory innervation area of the ulnar nerve occurred in 2 cases,which recovered in 3 months after treatment.There was no incision infection in all 50 cases,with a mean follow-up time of(15.0±4.7)months.At the last follow-up,VAS score decreased significantly[(0.6±1.3)vs(0.2±0.2),P=0.002],while MEPS score and elbow flexion and extension ROM increased significantly[(66.7±4.4)vs(87.5±6.8),P<0.001].Heterotopic ossification was observed in 1 case at the final follow-up.Conclusion Arthroscopic elbow joint release for the treatment of non-traumatic elbow stiffness can achieve satisfactory clinical outcomes,but elbow arthroscopy has a long learning curve and is difficult,and attention to the details of the surgical operation is needed to minimize complications.

关 键 词：关节镜 肘关节 僵硬 

分 类 号：R684.3[医药卫生—骨科学]