创伤后肘关节功能障碍的手术治疗

Operative treatment of post-traumatic functional disability of elbow joints

目的 通过对创伤后肘关节功能障碍病例的手术治疗 ,探讨创伤后肘关节活动受限的术前评估和手术方法。 方法 19例创伤后肘关节功能障碍患者 ,男 11例 ,女 8例 ;年龄 17～6 2岁 ,平均 33岁。平均手术时间为创伤后 9个月。术前采用Mayo评分法进行评分。除 2例外均采用肘关节外侧入路行关节清理术和关节囊松解术。术后功能锻炼 4个月 ,平均随访时间为 34个月。 结果 所有患者肘关节活动度由术前的平均 5 7°提高至术后的 98°(P <0 .0 5 )。评分由术前的 5 5分增加到 78分 (P <0 .0 5 )。 16例 (84.2 % )患者肘关节功能得到了改善。 结论 术前全面的评估。

Objective To discuss pre operative condition assessment and evaluate surgical procedure of post traumatic functional disability of elbow joints. Methods There were 19 cases (11 males, 8 females), at age of 17 62 years (mean 33 years). Operative intervention was 9 months. Preoperative scoring was done by Mayo elbow performance index. A lateral approach was applied in 17 patients, intra articular debridement and concurrent capsular release were required in the operation. Post operative functional exercise continued for 4 months. Mean follow up period was 34 months. Results Mean arc motion in 19 elbows joints had been improved from 57° to 98°after operation ( P <0.05). Mean score was increased from 55 to 78 ( P <0.05). Of all patients, 16 cases (84.2%) obtained significant improvement of active function of their elbows joints. Conclusions Thorough preoperative evaluation, appropriate operative techniques and supervised postoperative rehabilitation are key points for a successful treatment of post traumatic elbow joints with functional disability.