摘要
目的探讨肱尺关节成形术治疗肘关节强直的临床疗效。方法回顾性分析2012年10月至2015年10月我院采用肱尺关节成形术治疗创伤性肘关节强直的病人23例,其中男15例,女8例;年龄为29～56岁,平均为41.4岁,骨关节炎按Kellgren-Lawrence分级系统为Ⅱ级6例、Ⅲ级17例。术后镇痛、患肢石膏托外固定3 d后拆除并开始功能锻炼。记录术前、术后肘关节最大屈曲、伸直角度及屈伸活动范围,采用Mayo肘关节功能评分系统及疼痛视觉模拟量表(visual analogue scale,VAS)评估治疗效果。结果本组病人患侧肘关节的骨性异常均得到有效清除;病人肘关节屈曲角度、伸直角度、屈伸活动范围均得到了明显改善,屈伸活动范围由术前的32.39°±9.75°(14例≤30°、9例为31°～60°)提高至术后的120.87°±11.04°(23例病人的屈伸活动度均>90°),差异有统计学意义(t=28.090,P<0.001);病人术后的肘关节Mayo功能评分为(85.00±10.22)分,优良率为91.3%,显著优于术前的数值,差异有统计学意义(t=8.930,P<0.001);术后随着随访时间的延长,VAS评分值持续下降,术后各时间点的数值与术前评分比较,差异均具有统计学意义(P均<0.001)。结论肱尺关节成形术治疗创伤性肘关节强直的临床疗效可靠、安全,肘关节功能恢复良好。
Objective To evaluate the clinical efficacy of humeroulnar articulation arthroplasty for the stiff elbow.Methods Total of 23 patients(15 males,and 8 females)with a median age of 41.4(29-56)years diagnosed as posttraumatic stiff elbow were operated with humeroulnar articulation arthroplasty from October 2012 to October 2015.According to Kellgren-Lawrence classification,gradeⅡcovered 6 cases and gradeⅢ17 cases.All the patients were treated with a plaster external fixation to the elbow for the first 3 postoperative days.The maximum preoperative median and postoperative flexion,extension angles and the total flexion-extension(F/E)arc were recorded.Mayo elbow score and VAS score for pain were used to evaluate the elbow functions.Results The bone abnormality of the elbow joint was effectively removed.The elbow flexion angle,extension angle and F/E arc were all improved significantly.The F/E arc was increased from 32.39°±9.75°preoperatively(14 cases≤30°,9 cases 31°-60°)to 120.87°±11.04°postoperatively(23 cases>90°)with the difference being statistically significant(t=28.090,P<0.001).The Mayo function score after operation was 85.00±10.22,and the good rate was 91.3%,which was significantly better than that preoperation,and the difference was statistically significant(t=8.930,P<0.001).After the operation,the VAS score decreased continuously,and the differences were statistically significant(P<0.001 for all).Conclusion Humeroulnar articulation arthroplasty for a posttraumatic stiff elbow is associated with reliable clinical and functional outcomes.
作者
陈军号
李皓桓
刘远翔
李建平
彭飞
向绍齐
CHEN Jun-hao;LI Hao-huan;LIU Yuan-xiang;LI Jian-ping;PENG Fei;XIANG Shao-qi(Department of Orthopaedics,Renmin Hospital of Wuhan University,Wuhan 430060,China)
出处
《骨科》
CAS
2018年第4期285-289,共5页
ORTHOPAEDICS
基金
国家自然科学基金(81271347)
作者简介
通信作者:李皓桓,E-mail:lihaohuan@whu.edu.cn
