Systematic operative release for treatment of elbow post-traumatic contracture

Abstract

目的回顧性探討采用系統手術松解療法治療創傷后肘關節僵硬的療效。方法自1996-04—2010-05采用手術松解治療來自香港大學瑪麗醫院的26例創傷后肘關節僵硬,平均初次受傷后12個月進行手術松解,術中完全清除關節囊內、外的粘連。所有患者術后均使用支具固定,并在服用吲哚美辛下進行復康治療6周,平均隨訪25.6個月。通過比較手術前后關節活動范圍及Mayo肘關節功能評分評定療效。結果所有患者關節活動平均幅度由術前48°(080°)改善至末次隨訪時104°(40130°)。末次隨訪平均Mayo評分為87分。1例出現外側肘韌帶松弛并導致肘關節半脫位。結論采用系統手術松解治療創傷后肘關節僵硬可有效改善關節活動度及整體肘關節功能。 Objective To retrospectively investigate the curative effect of the open operative release for treatment of posttraumatic contracture of the elbow. Methods From April 1996 to May 2010, release was performed on 26 cases of post-traumatic contracture of the elbow by operation. The patients were from Queen Mary Hospital, Hong Kong. The mean operative time after the trauma was 12 months. The adhesion of the join was released completely. All the cases were fixed with the braces after the operations,received the rehabilitation, and took Indomatecin for 6 weeks. The mean following time was 25.6 months. The joint moving range and function before the operation and after the operation with Mayo Elbow Performance Score were compared. Results The join moving range was improved from 48°(0-80°) to 104°(40-130°). The mean final visit Mayo score was 87. One lateral elbow ligament relax case got the elbow subluxation. Conclusion The operative release treatment can improve the function of the post-traumatic contracture elbow effectively.