中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2015年
2期
85-89
,共5页
郭祁%何大炜%孙宁%查晔军%蒋协远
郭祁%何大煒%孫寧%查曄軍%蔣協遠
곽기%하대위%손저%사엽군%장협원
创伤和损伤%肘关节%关节挛缩
創傷和損傷%肘關節%關節攣縮
창상화손상%주관절%관절련축
Wounds and injuries%Elbow joint%Arthrogryposis
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.
目的 研究創傷後肘關節僵硬的髮病情況.方法 收集1997年1月至2013年12月北京積水潭醫院收治的553例創傷後肘關節僵硬患者的病歷資料進行迴顧性研究.記錄患者的臨床資料和影像學資料.結果 553例中男性366例,女性187例;平均年齡為35歲(12 ～ 76歲),以＞30 ～40歲年齡組的患者最多(166例,佔30.8％).中低能量損傷301例(54.4％),高能量損傷227例(41.1％);關節外骨摺、損傷60例(10.8％),平均固定時間6.1週,關節內骨摺、脫位493例(89.2％),平均固定時間4.9週;肘關節活動範圍平均30°(0°～110°);肘部有異位骨化者457例(82.6％),無異位骨化96例(17.4％).結論 創傷後肘關節僵硬通常纍及年輕、活躍人群,在臨床工作中應重視低能量損傷、關節外骨摺和簡單關節內骨摺的治療,避免超過3週的製動,採取適噹的手術固定方式,早期進行以主動功能鍛煉為主,輔以輕柔的被動練習,另外需積極應對異位骨化的髮生.
목적 연구창상후주관절강경적발병정황.방법 수집1997년1월지2013년12월북경적수담의원수치적553례창상후주관절강경환자적병력자료진행회고성연구.기록환자적림상자료화영상학자료.결과 553례중남성366례,녀성187례;평균년령위35세(12 ～ 76세),이＞30 ～40세년령조적환자최다(166례,점30.8％).중저능량손상301례(54.4％),고능량손상227례(41.1％);관절외골절、손상60례(10.8％),평균고정시간6.1주,관절내골절、탈위493례(89.2％),평균고정시간4.9주;주관절활동범위평균30°(0°～110°);주부유이위골화자457례(82.6％),무이위골화96례(17.4％).결론 창상후주관절강경통상루급년경、활약인군,재림상공작중응중시저능량손상、관절외골절화간단관절내골절적치료,피면초과3주적제동,채취괄당적수술고정방식,조기진행이주동공능단련위주,보이경유적피동연습,령외수적겁응대이위골화적발생.
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' immobilization,and the patients of intraarticular fractures or dislocations were 493 cases (89％) with average 4.9 weeks' 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.
