南昌大学学报(医学版)
南昌大學學報(醫學版)
남창대학학보(의학판)
ACTA ACADEMIAE MEDICINAE JIANGXI
2014年
5期
43-45,53
,共4页
关节镜%桡骨小头陈旧性骨折%肘关节功能障碍%桡骨小头切除术
關節鏡%橈骨小頭陳舊性骨摺%肘關節功能障礙%橈骨小頭切除術
관절경%뇨골소두진구성골절%주관절공능장애%뇨골소두절제술
arthroscopy%old radial head fractures%elbow dysfunction%radial head resection
目的:探讨关节镜下桡骨小头切除术治疗桡骨小头陈旧性骨折的临床疗效。方法对13例桡骨小头陈旧性骨折患者在臂丛神经阻滞麻醉下行肘关节镜下桡骨小头切除术、关节腔清理、瘢痕滑膜切除及适当的关节囊松解等处理。术后给予镇痛配合下早期行功能康复锻炼。对13例患者术前、术后 Mayo肘关节功能评分、肘关节屈曲角度、肘关节伸直角度及肘关节屈伸活动范围进行比较。结果13例患者术后随访5~18个月,平均10.3个月。Mayo肘关节功能评分:术前50~75分,平均(65.38±6.91)分;术后70~90分,平均(78.85±7.12)分,术前、术后 Mayo肘关节功能评分值比较差异有统计学意义(z=-3.072,P=0.002)。肘关节屈曲角度:术前30°~80°,平均(56.54±12.84)°,术后90°~120°,平均(106.54±11.44)°,较术前改善50°;肘关节伸直角度:术前-70°~0°,平均(-21.92±27.12)°,术后-15°~0°,平均(-3.85±5.06)°,较术前改善18.07°;肘关节屈伸范围:术前0°~60°,平均(34.62±21.23)°,术后80°~120°,平均(102.69±10.73)°,术前、术后肘关节屈伸范围值比较差异有统计学意义(z=-3.189,P=0.001)。无一例出现神经、血管损伤,关节感染和异位骨化等并发症。结论关节镜下桡骨小头切除术具有创伤小、出血少、术后恢复快及并发症少等优点,对于桡骨小头陈旧性骨折伴肘关节功能障碍的患者,是一种安全、有效、可行的微创治疗方式。
目的:探討關節鏡下橈骨小頭切除術治療橈骨小頭陳舊性骨摺的臨床療效。方法對13例橈骨小頭陳舊性骨摺患者在臂叢神經阻滯痳醉下行肘關節鏡下橈骨小頭切除術、關節腔清理、瘢痕滑膜切除及適噹的關節囊鬆解等處理。術後給予鎮痛配閤下早期行功能康複鍛煉。對13例患者術前、術後 Mayo肘關節功能評分、肘關節屈麯角度、肘關節伸直角度及肘關節屈伸活動範圍進行比較。結果13例患者術後隨訪5~18箇月,平均10.3箇月。Mayo肘關節功能評分:術前50~75分,平均(65.38±6.91)分;術後70~90分,平均(78.85±7.12)分,術前、術後 Mayo肘關節功能評分值比較差異有統計學意義(z=-3.072,P=0.002)。肘關節屈麯角度:術前30°~80°,平均(56.54±12.84)°,術後90°~120°,平均(106.54±11.44)°,較術前改善50°;肘關節伸直角度:術前-70°~0°,平均(-21.92±27.12)°,術後-15°~0°,平均(-3.85±5.06)°,較術前改善18.07°;肘關節屈伸範圍:術前0°~60°,平均(34.62±21.23)°,術後80°~120°,平均(102.69±10.73)°,術前、術後肘關節屈伸範圍值比較差異有統計學意義(z=-3.189,P=0.001)。無一例齣現神經、血管損傷,關節感染和異位骨化等併髮癥。結論關節鏡下橈骨小頭切除術具有創傷小、齣血少、術後恢複快及併髮癥少等優點,對于橈骨小頭陳舊性骨摺伴肘關節功能障礙的患者,是一種安全、有效、可行的微創治療方式。
목적:탐토관절경하뇨골소두절제술치료뇨골소두진구성골절적림상료효。방법대13례뇨골소두진구성골절환자재비총신경조체마취하행주관절경하뇨골소두절제술、관절강청리、반흔활막절제급괄당적관절낭송해등처리。술후급여진통배합하조기행공능강복단련。대13례환자술전、술후 Mayo주관절공능평분、주관절굴곡각도、주관절신직각도급주관절굴신활동범위진행비교。결과13례환자술후수방5~18개월,평균10.3개월。Mayo주관절공능평분:술전50~75분,평균(65.38±6.91)분;술후70~90분,평균(78.85±7.12)분,술전、술후 Mayo주관절공능평분치비교차이유통계학의의(z=-3.072,P=0.002)。주관절굴곡각도:술전30°~80°,평균(56.54±12.84)°,술후90°~120°,평균(106.54±11.44)°,교술전개선50°;주관절신직각도:술전-70°~0°,평균(-21.92±27.12)°,술후-15°~0°,평균(-3.85±5.06)°,교술전개선18.07°;주관절굴신범위:술전0°~60°,평균(34.62±21.23)°,술후80°~120°,평균(102.69±10.73)°,술전、술후주관절굴신범위치비교차이유통계학의의(z=-3.189,P=0.001)。무일례출현신경、혈관손상,관절감염화이위골화등병발증。결론관절경하뇨골소두절제술구유창상소、출혈소、술후회복쾌급병발증소등우점,대우뇨골소두진구성골절반주관절공능장애적환자,시일충안전、유효、가행적미창치료방식。
Objective To investigate the clinical efficacy of arthroscopic radial head excision for old radial head fractures.Methods Thirteen patients with old radial head fractures were treated with arthroscopic radial head excision,joint cavity debridement,synovectomy and proper joint capsule release under brachial plexus anesthesia.Postoperative analgesia and early functional re-habilitation exercise were performed in all patients.Mayo elbow performance score,elbow flexion angle,elbow extension angle and elbow motion range were determined before and after operation. Results Patients were followed up for an average of 10.3 months(range,5 to 18 months).Mayo elbow performance score significantly increased from preoperative 65.38±6.91(range,50 to 75) to postoperative 78.85±7.12(range,70 to 90)(z=-3.072,P=0.002).Elbow flexion angle was improved from preoperative(56.54 ± 12.84)°(range,30° to 80°)to postoperative(106.54 ± 11.44)°(range,90°to 120°).Elbow extension angle was improved from preoperative(-21.92± 27.12)°(range,-70°to 0°)to postoperative(-3.85±5.06)°(range,-15°to 0°).Elbow motion range significantly increased from preoperative(34.62±21.23)°(range,0°to 60°)to postoperative (102.69±10.73)°(range,80°to 120°)(z=-3.189,P=0.001).No patients had nerve injury, blood vessel damage,j oint infection,ectopic ossification and other complications.Conclusion Ar-throscopic radial head resection is associated with smaller incision,less bleeding,faster recovery and fewer complications,and is safe,effective and feasible for old radial head fractures associated with elbow dysfunction.