摘要
目的 研究创伤后肘关节僵硬的发病情况.方法 收集1997年1月至2013年12月北京积水潭医院收治的553例创伤后肘关节僵硬患者的病历资料进行回顾性研究.记录患者的临床资料和影像学资料.结果 553例中男性366例,女性187例;平均年龄为35岁（12 ～ 76岁）,以＞30 ～40岁年龄组的患者最多（166例,占30.8％）.中低能量损伤301例（54.4％）,高能量损伤227例（41.1％）;关节外骨折、损伤60例（10.8％）,平均固定时间6.1周,关节内骨折、脱位493例（89.2％）,平均固定时间4.9周;肘关节活动范围平均30°（0°～110°）;肘部有异位骨化者457例（82.6％）,无异位骨化96例（17.4％）.结论 创伤后肘关节僵硬通常累及年轻、活跃人群,在临床工作中应重视低能量损伤、关节外骨折和简单关节内骨折的治疗,避免超过3周的制动,采取适当的手术固定方式,早期进行以主动功能锻炼为主,辅以轻柔的被动练习,另外需积极应对异位骨化的发生.
Objective To investigate the etiology of posttraumatic elbow stiffness and distinguish features of the patients by retrospective analyzing their records.Methods This was a retrospective analysis of 553 patients with posttraumatic elbow stiffness who underwent arthrolysis performed in Beijing Jishuitan Hospital from January 1997 to December 2013.The patients＇ clinical and radiographic results were collected,and encoded into a survey database.Results Total 366 male and 189 female patients were treated by the same treating team.The average age of 553 cases was 35 years （12-76 years）.And the largest number of 〉30-40 years old group was 166（30.8%）.There were 301 cases （54.4%） causing by low-energy injury and 227 cases （41.1%） by high-energy injury.The patients of extra-articular fractures and injuries were 60 cases （10.8%） with average 6.1 weeks＆#39; immobilization,and the patients of intraarticular fractures or dislocations were 493 cases （89%） with average 4.9 weeks＆#39; immobilization.The mean range of motion of extension and flexion was 30° （0°-110°）.Four hundreds and fifty-seven patients （82.6%） were diagnosed with Heterotopic Ossification （HO）,the other 96 patients without HO.Conclusions Elbow stiffness commonly occurs following trauma.More attention needs to pay on the treatment procedures for minor injuries,extra-articular fractures and simple intra-articular fractures.It is not appropriate to immobilize the elbow more than 3 weeks,even for those complicated elbow fracture and dislocation.Heterotopic ossification has significant negative impact on the function of elbow.However its pathogenesis is still not clear,which need more fundamental research.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2015年第2期85-89,共5页
Chinese Journal of Surgery
关键词
创伤和损伤
肘关节
关节挛缩
Wounds and injuries
Elbow joint
Arthrogryposis
