手术松解联合外支架治疗伴疼痛的肘关节功能障碍近期疗效观察

发布时间：2018-12-11 02:48

【摘要】：目的探讨手术松解联合外支架治疗合并疼痛的创伤后肘关节功能障碍的临床效果。方法 2011年1月至2014年12月,采用手术治疗32例合并有疼痛的创伤后肘关节功能障碍患者。男22例,女10例,年龄18~65岁,平均39岁。32例中,25例轻中度疼痛患者作单纯肘关节松解术;4例重度疼痛患者合并有肘关节陈旧性脱位,在术中充分松解肘关节后直视下复位肘关节;3例肘关节炎严重,疼痛剧烈患者在作肘关节松解术同时,作真皮移植间隔式肘关节成形术。共26例患者使用了铰链式外固定架辅助早期功能锻炼。结果术后随访12~18个月,平均14个月。所有患者肘关节活动范围和疼痛症状得到明显改善。术后关节功能改善程度:2例极重度僵硬改善为中度僵硬,19例中度以上僵硬患者改善为轻度僵硬,其余11例改善为无僵硬,改善率100%;术后疼痛缓解情况:6例中重度疼痛缓解为轻度疼痛,其余26例疼痛消失,疼痛缓解率100%。肘关节功能评定采用Mayo综合评分。术前评分:优0例,良6例,可14例,差12例。术后评分:优20例,良8例,可4例,优良率87.5%。术后和术前比较差异有统计学意义(P0.05)。结论手术松解联合外支架有利于术后早期功能康复和恢复肘关节僵硬术后的屈伸功能,对陈旧性脱位或肘关节炎引起的疼痛也可获得较好疗效。
[Abstract]:Objective to investigate the clinical effect of surgical release combined with external stent in the treatment of post-traumatic elbow dysfunction. Methods from January 2011 to December 2014, 32 patients with post-traumatic elbow dysfunction were treated with surgery. There were 22 males and 10 females aged 1865 years with an average age of 39.25 of 32 patients with mild to moderate pain underwent simple elbow release. There were 4 cases of severe pain complicated with old dislocation of elbow joint. After fully releasing the elbow joint during the operation, the elbow joint was reduced under direct vision. Three patients with severe elbow arthritis and severe pain were treated with dermis graft septal elbow arthroplasty at the same time. A total of 26 patients were treated with hinged external fixator to assist early functional exercise. Results the follow-up was 12 ~ 18 months (mean 14 months). The range of elbow motion and pain symptoms were significantly improved in all patients. The degree of improvement of joint function after operation: 2 cases with extremely severe stiffness were improved to moderate stiffness, 19 cases with moderate stiffness were improved to mild stiffness, the remaining 11 cases were improved to no stiffness, the improvement rate was 100%. Postoperative pain relief: 6 cases of moderate and severe pain relief to mild pain, the remaining 26 cases of pain disappeared, pain relief rate 100 kum. The function of elbow joint was evaluated with Mayo comprehensive score. Preoperative score: excellent in 0 cases, good in 6 cases, fair in 14 cases, poor in 12 cases. Postoperative score: excellent 20 cases, good 8 cases, fair 4 cases, excellent and good rate 87.5%. Postoperative and preoperative differences were statistically significant (P0.05). Conclusion Surgical release combined with external stent is beneficial to early functional rehabilitation and recovery of flexion and extension function of elbow joint after operation. It can also obtain good curative effect on pain caused by old dislocation or elbow arthritis.
【作者单位】：贵州省贵阳市第四人民医院骨3科;
【分类号】：R687.4

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