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切开松解联合铰链式外固定支架修复极重度肘关节僵硬 被引量:11

Open release combined with hinged external fixator repairs extremely severe elbow stiffness
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摘要 背景:创伤性关节炎一旦发生,关节的退变过程将不可避免。在中度以下的肘关节僵硬临床治疗中,传统肘关节僵硬松解是其首选修复方法。但是,在极重度肘关节僵硬患者临床治疗中的疗效存在着诸多的争议,其矛盾焦点在于传统肘关节僵硬松解实施后关节面的损伤。目的:观察切开松解联合铰链式外固定支架对极重度肘关节僵硬患者的修复效果。方法:选取韶关市粤北人民医院骨三科2012年5月至2014年7月收治的52例极重度肘关节僵硬患者为研究对象,在医院伦理委员会批准、所有患者知情下分为对照组与研究组各26例,对照组采用传统肘关节僵硬松解方案进行治疗,研究组采用切开松解联合铰链式外固定支架进行治疗,比较两组患者肘关节屈伸活动度和Mayo肘关节功能评分变化情况。结果与结论:研究组患者通过采用切开松解联合铰链式外固定支架进行治疗,术后功能评定优良率为96%,肘关节屈伸活动度为(117.5±20.5)°,Mayo肘关节功能评分为(88.5±11.5)分;与对照组77%、(93.5±18.5)°、(76.5±9.5)分相比,差异有显著性意义(P<0.05)。提示切开松解联合铰链式外固定支架能够显著改善极重度肘关节僵硬患者的肘关节功能,且利于术后康复锻炼活动开展,具有较高的临床应用价值。 BACKGROUND: Once traumatic arthritis appears, degeneration of the joints will be inevitable. In the clinical treatment of moderate or less stiff elbow, traditional elbow stiffness release is the preferred repair method. However, its therapeutic effect is controversial in the clinical treatment of very severe elbow stiffness. The focus on conflict is articular surface damage after the implementation of the traditional release of elbow stiffness. OBJECTIVE: To observe the repair effect of open release combined with hinged external fixator on extremely severe elbow stiffness.METHODS: A total of 52 patients with extremely severe elbow joint stiffness were selected from the Third Department of Orthopedics, Yuebei People’s Hospital from May 2012 to July 2014. All patients signed the informed consent. In accordance with the approval of Hospital Ethics Committee, they were divided into control and study groups(n=26). Control group received the traditional elbow stiffness release. Study group received open release combined with hinged external fixator. The changes in flexion-extension range-of-motion and Mayo elbow joint function score were compared between the two groups.RESULTS AND CONCLUSION: After treatment with open release combined with hinged external fixator, significant differences in excellent and good rate, range-of-motion of flexion-extension and Mayo elbow joint function score were detected between the study group [96%,(117.5±20.5)°,(88.5±11.5) points] and the control group [77%,(93.5±18.5)°,(76.5±9.5) points](P 〈 0.05). These results indicated that open release combined with hinged external fixator significantly improved elbow joint function in patients with extremely severe elbow stiffness, facilitated postoperative rehabilitation exercise activities, and had high value of clinical application.
出处 《中国组织工程研究》 CAS 北大核心 2015年第4期578-583,共6页 Chinese Journal of Tissue Engineering Research
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