肘关节镜微创治疗肘关节屈伸功能障碍

Arthroscopic treatment of elbow joint motion limitation

目的探讨肘关节镜微创治疗肘关节屈伸功能障碍的适应证、手术方法及术后康复锻炼。方法对自2008年11月～2011年8月收治的29例肘关节屈仲活动功能障碍均行肘关节镜下松解清理术，术后按统一标准化方案行康复功能训练，对比术前、术后肘关节屈伸活动度，采用Mayo肘关节功能评分进行比较。结果患者术后获随访8—16个月，平均11．3个月，21例肘关节屈伸活动功能均有很大程度的改善。术前平均主动伸直活动度为（38±24）°，屈曲活动度为（102±19）°。术后平均主动伸直活动度为（10±7）°，屈曲活动度为（118±15）°，术前、术后伸直活动度改善（27．8±10．4）°，术前、术后屈曲活动度增加（16．4±3．3）°，术前及术后屈、伸活动度差异有统计学意义（P〈0．05）。采用Mayo肘关节功能评分进行比较，术前良8例，中15例，差6例；术后优8例，良14例，中5例，差2例。结论肘关节镜微创治疗肘关节屈伸功能障碍具有创伤小、康复快、是一种有效治疗肘关节屈伸功能障碍的方法。

Objective To explore the indication, operation method and rehabilitation exercises of arthroscopic treatment for elbow motion limitation. Methods From November 2008 to August 2011, 29 elbows in 29 patients were treated with an arthroscopic procedure for the limitation of elbow joint motion. Postoperative exercises were taken in unified standards. All elbows were assessed by ranging of motion （ROM） and Mayo score before and after surgery. Results At an average of 11.3 month follow-up（8±16 months）, significant improvements of elbow motion （in beth flexion and extension） were gained in all 29 patients. The mean maximum extension was （38±24）° and the mean maximum flexion was （102±19）° before operation, and （10±7）° in extension and （118±15）°in flexion after operation. The mean improvement in extension was （27.8±10.4）°, and the mean improvement in flexion was （16.4±3.3）°. The measurement results had statistical significance. Preoperative Mayo assessment： good in 8 cases, fair in 16 and bad in 6 cases; postoperative Mayo assessment： excellent in 8 cases, good in 14 cases, fair in 5 and bad in 2 cases. Conclusion Arthroscopic surgery has less surgical morbidity and earlier rehabilitation, it appears to be a satisfactory and effective management for the limitation of elbow joint motion.