内外侧联合入路合并早期支具固定治疗复杂肘关节脱位的临床疗效

Clinical effect of combined internal and external approach combined with early brace fixation in the treatment of complex elbow dislocation

目的探讨内外侧联合入路合并早期支具固定治疗复杂肘关节脱位的临床效果。方法回顾性分析解放军第175医院骨科2014年1月—2016年12月收治的复杂肘关节脱位患者86例,男性53例,女性33例;年龄21～55岁。根据手术方法分为手术组54例(内外侧联合入路手术治疗)和非手术组32例(非手术治疗),对比两组术后骨折愈合时间、术后3、6个月肘关节屈伸,旋转范围以及肘关节功能评分。结果手术组的骨折愈合时间(13. 4±1. 6)周,明显少于非手术组(14. 7±1. 8)周;术后3、6个月,手术组的肘关节屈伸、旋转度数均显著高于同期的非手术组,肘关节疼痛、活动范围、稳定性及功能评分也均显著高于同期的非手术组;术后6个月,手术组的肘关节功能优于非手术组;上述比较差异均具有统计学意义(P <0. 05)。结论内外侧联合入路合并早期支具固定治疗复杂肘关节脱位对患者术后肘关节功能恢复有利,愈合时间短,促进肘关节功能恢复,值得临床上推广。

Objective To investigate the clinical effect of combined medial and lateral approach combined with early brace fixation in the treatment of complex elbow dislocation. Methods Totally 86 patients with complex elbow dislocation were retrospectively selected from the Department of Orthopedics,175 Hospital of PLA from Jan.2014 to Dec.2016. There were 53 males and 33 females,aged 21-55. According to the operation method,54 cases were divided into operation group （internal and external combined approach） and 32 cases （non-operation group）. The fracture healing time,the range of elbow flexion and extension,rotation and elbow function score were compared between the two groups. Results The healing time of the operation group was （13.4＋ 1.6） weeks,which was significantly shorter than that of the non-operation group （14.7＋ 1.8） weeks; the degree of flexion,extension and rotation of the elbow joint in the operation group were significantly higher than those in the non-operation group 3 and 6 months after operation,and the scores of pain,range of motion,stability and function of the elbow joint were significantly higher than those in the non-operation group at the same time. Six months after operation,the elbow joint function of the operation group was better than that of the non-operation group （ P 〈0.05）. Conclusion The treatment of complex dislocation of the elbow by combined medial and lateral approach with early brace fixation is beneficial to the recovery of elbow joint function with less healing time and can promote the recovery of elbow joint function.