發(fā)布時(shí)間：2018-12-11 02:48

【摘要】：目的探討手術(shù)松解聯(lián)合外支架治療合并疼痛的創(chuàng)傷后肘關(guān)節(jié)功能障礙的臨床效果。方法 2011年1月至2014年12月,采用手術(shù)治療32例合并有疼痛的創(chuàng)傷后肘關(guān)節(jié)功能障礙患者。男22例,女10例,年齡18~65歲,平均39歲。32例中,25例輕中度疼痛患者作單純肘關(guān)節(jié)松解術(shù);4例重度疼痛患者合并有肘關(guān)節(jié)陳舊性脫位,在術(shù)中充分松解肘關(guān)節(jié)后直視下復(fù)位肘關(guān)節(jié);3例肘關(guān)節(jié)炎嚴(yán)重,疼痛劇烈患者在作肘關(guān)節(jié)松解術(shù)同時(shí),作真皮移植間隔式肘關(guān)節(jié)成形術(shù)。共26例患者使用了鉸鏈?zhǔn)酵夤潭茌o助早期功能鍛煉。結(jié)果術(shù)后隨訪12~18個(gè)月,平均14個(gè)月。所有患者肘關(guān)節(jié)活動(dòng)范圍和疼痛癥狀得到明顯改善。術(shù)后關(guān)節(jié)功能改善程度:2例極重度僵硬改善為中度僵硬,19例中度以上僵硬患者改善為輕度僵硬,其余11例改善為無(wú)僵硬,改善率100%;術(shù)后疼痛緩解情況:6例中重度疼痛緩解為輕度疼痛,其余26例疼痛消失,疼痛緩解率100%。肘關(guān)節(jié)功能評(píng)定采用Mayo綜合評(píng)分。術(shù)前評(píng)分:優(yōu)0例,良6例,可14例,差12例。術(shù)后評(píng)分:優(yōu)20例,良8例,可4例,優(yōu)良率87.5%。術(shù)后和術(shù)前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論手術(shù)松解聯(lián)合外支架有利于術(shù)后早期功能康復(fù)和恢復(fù)肘關(guān)節(jié)僵硬術(shù)后的屈伸功能,對(duì)陳舊性脫位或肘關(guān)節(jié)炎引起的疼痛也可獲得較好療效。
[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.
【作者單位】： 貴州省貴陽(yáng)市第四人民醫(yī)院骨3科;
【分類(lèi)號(hào)】：R687.4

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