铰链式外固定支架在治疗肘关节骨折术后僵硬中的应用

摘要

[目的]分析比较不同术式治疗肘关节骨折术后僵硬的临床疗效。[方法]2005年2月～2012年6月间43例肘部骨折术后继发关节强直僵硬患者，随机分为2组，其中应用铰链式外固定支架行肘关节松解术者23例为A组，常规肘关节松解者20例为B组。治疗后随访12～26个月，以关节活动度及肘关节功能评分评价疗效，并观察2组并发症发生情况。[结果]治疗后随访12～26个月，A组肘关节平均屈伸活动度达116.5度，肘关节功能评分85.7分；B组肘关节平均屈伸活动度达75.3度，肘关节功能评分61.5分，2组比较差异均有统计学意义(P<0.05)。术后并发症尺神经损伤B组2例，A组无；术后切口感染、皮下血肿、切口愈合不良B组3例，A组无。[结论]采用铰链外固定支架松解术治疗创伤后肘关节僵硬疗效显著，可有效增加僵硬肘关节的活动度及改善关节功能，并减少术后并发症的发生。%[Objective]To review the treatment of 23 cases of elbow arthrogryposis, summarize the experience of the treatment for elbow arthrogryposis releasing and application of hinged external fixator. [Methods] 23 cases of patients with elbow arthrogryposis underwent elbow arthrogryposis releasing and application of hinged external fixation. [Results]The patients with elbow flexion group mean maximum flexion improved from preoperative 20.1 ° to 110.2° after operation, limited group of patients mean maximum extension activity from preoperative 74.5 ° to 22.2° after operation, both flexion and extension in limited group, respectively from preoperative 45.3° and 52° degrees for the improvement of postoperative 20.2° and 100.2°. [Conclusion] With significant effect on treating the post-traumatic elbow arthrogryposis, the technique of treatment elbow arthrogryposis with Hinged external fixator also effectively increased the elbow maximum flexion activity as wel as elbow extension activity.