关节镜下松解创伤后肘关节僵硬的疗效分析

Evaluation of arthroscopic arthrolysis in the treatment of posttraumatic elbow stiffness

目的分析关节镜视下肘关节松解术治疗创伤后肘关节僵硬的临床疗效。方法回顾性分析自2016年10月至2019年8月我科在关节镜视下肘关节松解术治疗的31例创伤后肘关节僵硬患者,对肘关节术前、术后关节活动范围、Mayo肘关节功能评分情况进行评估。结果术后26例患者随访时间超过6个月,6~62个月,平均27.8个月。最终肘关节屈曲活动度由术前的(95.4±19.7)°提高到术后(132.8±9.2)°,伸直活动度由术前的(-34.5±16.4)°提高到术后(-15.5±12.5)°。肘关节活动范围由术前的(60.8±28.8)°提高到术后(117.2±19.2)°,Mayo肘关节功能评分由术前的62.9±16.8提高到术后89.8±11.1.术前与术后肘关节活动范围及Mayo肘关节功能评分差异均有统计学意义(P<0.001)。其中2例患者出现了并发症,1例为术后肘关节血肿,另1例为肘关节僵硬复发,均行二次手术,在最终随访时获得满意疗效。所有患者均未发生感染及神经损伤并发症。结论关节镜视下肘关节松解术治疗创伤后肘关节僵硬可取得满意的临床疗效。

Objective To analyze the clinical efficacy of arthroscopic arthrolysis in the treatment of posttraumatic elbow sifess.Methods Thirty-one patients with posttraumatic elbow stiffness treated by arthroscopic arthrolysis in our department from October 2016 to August 2019 were analyzed retrospectively.The range of motion(ROM)and Mayo elbow performance score(MEPS)before and after elbow operation were evaluated.Results Twenty-six patients were follow-up for more than 6 months,6 to 62 months,with an average of 27.8 months.Finally,the elbow flexion range of motion increased from(95.4±19.7)°before operation to(132.8±9.2)。after operation,and the extension range of motion increased from(-34.5±6.4)°before operation to(-15.5±12.5)°after operation.The ROM of elbow joint increased from(60.8±28.8)°before operation to(117.2±19.2)°after operation,and MEPS increased from 62.9+16.8 to 89.8±11.1 after operation.There were significant differences in elbow ROM and MEPS before and after operation(P<0.001).Two patients had complications.One was postoperative elbow hematoma and the other was recurrence of elbow stiffness.Both patients underwent secondary surgery and achieved satisfactory results at the final follow-up.All the patients had no complications of infection and nerve injury.Conclusion The arthroscopic arthrolysis in the treatment of posttraumatic elbow stiffness can achieve satisfactory clinical efficacy.