肘部有神经病变的非神经源性骨化的外科治疗

Surgical treatment of non neurogenic elbow heterotopic ossification patients with ulnar neuropathy.

目的 探讨肘部有神经病变的非神经源性骨化的外科治疗。 方法 对湘雅医院 16个非神经源性骨化及尺神经麻痹患者行手术治疗 ,观察患肢术前、术后最后一次随访的感觉、运动情况。 结果 16个患者肘关节活动度平均运动度由术前 46.7度恢复到术后 10 5 8度 ,较术前明显改善 (P <0 0 1)。 15例尺神经麻痹症状完全恢复 ,1例尺神经麻痹持续 1年的患者无恢复。 结论 对于已僵硬的肘关节 ,重复暴力处理将会加重关节的损伤 ,应予以避免 :早期异位骨化组织切除及尺神经减压联合轻柔物理疗法会中止病变加重 。

Objective To observe the results of surgical treatment of nonneurogenic heterotopic ossification patients complicated with ulnar neuropathy. Methods Surgical treatment of 16 patients diagnosed as heterotopic ossification at elbow and ulnar palsy without neurological injury in Xiangya Municipal Second Hospital was carried out and the sense and mobility of the injured upper limbs were observed before and after operation. Results The mobility and average range of motion of the elbows in the 16 patients were apparently improved after the operation being increased from 46.7° before operation to 105.8° about 21 months after operation(P<0.01). The 15 patients with ulnar palsy were recovered and no improvement in one patients. Conclusion Forceful and repeated treatment of stiffened elbow may add further damage to the injured elbows thus precaution is recommended. Excellent results can be achieved resecting the heterotopic ossification tissue plus ulnar nerve decompression and physical therapy.