Objective To study the effect of open arthrolysis combined with external fixator in the treatment of extremely severe elbow stiffness.Methods A total of 60 patients with extremely severe elbow stiffness,admitted to De-partment of Surgery of Foshan Fifth People's Hospital from May 2014 to May 2016,were selected and divided into the observation group and the control group according to random number table method,with 30 cases in each group.The ob-servation group received open arthrolysis and external fixator,while the control group received traditional rigid lysis of elbow joint.The basic situation for operation,postoperative complications,rehabilitation of joint motion and elbow joint activity before and one year after the operation were recorded and compared between the two groups.Results The op-eration time was(105.26±18.31)minutes in the observation group versus(80.07±11.74)minutes in the control group(P<0.05).There was no significant difference in the length of incision and the amount of bleeding between the two groups (P>0.05).The elbow function scores of the two groups after 6 and 12 mouths were significantly higher than those before the operation(P<0.05).The scores of elbow joint function 3 mouths,6 mouths and 1 year after the operation in the obser-vation group were(59.31±9.65),(75.26±12.08),(84.39±15.15),respectively,which were significantly higher than corre-sponding(50.22±10.33),(67.82±12.23),(76.24±14.09)in the control group(P<0.05).The curative effect rate of joint motion rehabilitation was 93.10% in the observation group versus 67.86% in the control group(P<0.05).The flexion and mobility of the two groups after 3,6 and 12 mouths were significantly higher than those before the operation(P<0.05). The flexion and mobility of the observation group 3 mouths,6 mouths and 1 year after the operation were significantly higher than those in the control group,and the extension degree was significantly lower than that in the control group(P<0.05). The postoperative complication was 13.33% in the observation group versus 23.33% in the control group (P>0.05). Conclusion Open arthrolysis combined with external fixation for severe elbow stiffness can significantly im-prove the elbow joint function and mobility of the elbow joint,which has high safety and is worthy of clinical promotion.%目的 研究切开松解联合外固定架修复极重度肘关节僵硬的临床疗效.方法 纳入2014年5月至2016年5月佛山第五人民医院外科收治的60例极重度肘关节僵硬患者作为研究对象,采用随机抽签法分为观察组和对照组各30例.观察组行切开松解联合外固定架修复术,对照组行传统肘关节僵硬松解术.记录并比较两组患者的手术情况、术后并发症以及手术前和术后1年内患者关节活动度和肘关节活动功能恢复情况.结果 观察组患者的手术时间为(105.26±18.31)min,明显短于对照组的(80.07±11.74)min,差异有统计学意义(P<0.05),而两组患者的手术切口长度和术中出血量比较差异均无统计学意义(P>0.05);两组术后6个月和12个月时的肘关节功能评分均明显高于术前,差异均有统计学意义(P<0.05);观察组患者术后3个月、6个月及1年时肘关节功能评分分别为(59.31±9.65)分、(75.26±12.08)分及(84.39±15.15)分,均明显高于对照组的(50.22±10.33)分、(67.82±12.23)分及(76.24± 14.09)分,差异均有统计学意义(P<0.05);术后1年,观察组患者肘关节恢复优良率为93.10%,对照组为67.86%,差异有统计学意义(P<0.05);两组患者术后3个月、6个月及12个月时屈曲度和活动度较术前明显升高,伸展度较术前明显降低,差异均有统计学意义(P<0.05),观察组术后3个月、6个月及12个月屈曲度和活动度明显高于对照组,伸展度明显低于对照组,差异均有统计学意义(P<0.05).观察组患者术后并发症发生率为13.33%,低于对照组的23.33%,但差异无统计学意义(P>0.05).结论 切开松解联合外固定架修复术用于极重度肘关节僵硬患者能显著改善术后患者肘关节活动功能和关节活动度,且具有较高的安全性,值得临床推广.
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