中国组织工程研究
中國組織工程研究
중국조직공정연구
Journal of Clinical Rehabilitative Tissue Engineering Research
2015年
4期
578-583
,共6页
植入物%关节植入物%肘关节僵硬%铰链式外固定支架%切开松解%肘关节屈伸活动度
植入物%關節植入物%肘關節僵硬%鉸鏈式外固定支架%切開鬆解%肘關節屈伸活動度
식입물%관절식입물%주관절강경%교련식외고정지가%절개송해%주관절굴신활동도
Subject headings：Elbow Joint%External Fixators%Joint Capsule Release
背景：创伤性关节炎一旦发生，关节的退变过程将不可避免。在中度以下的肘关节僵硬临床治疗中，传统肘关节僵硬松解是其首选修复方法。但是，在极重度肘关节僵硬患者临床治疗中的疗效存在着诸多的争议，其矛盾焦点在于传统肘关节僵硬松解实施后关节面的损伤。<br> 目的：观察切开松解联合铰链式外固定支架对极重度肘关节僵硬患者的修复效果。<br> 方法：选取韶关市粤北人民医院骨三科2012年5月至2014年7月收治的52例极重度肘关节僵硬患者为研究对象，在医院伦理委员会批准、所有患者知情下分为对照组与研究组各26例，对照组采用传统肘关节僵硬松解方案进行治疗，研究组采用切开松解联合铰链式外固定支架进行治疗，比较两组患者肘关节屈伸活动度和Mayo肘关节功能评分变化情况。<br> 结果与结论：研究组患者通过采用切开松解联合铰链式外固定支架进行治疗，术后功能评定优良率为96%，肘关节屈伸活动度为(117.5±20.5)°，Mayo肘关节功能评分为(88.5±11.5)分；与对照组77%、(93.5±18.5)°、(76.5±9.5)分相比，差异有显著性意义(P <0.05)。提示切开松解联合铰链式外固定支架能够显著改善极重度肘关节僵硬患者的肘关节功能，且利于术后康复锻炼活动开展，具有较高的临床应用价值。
揹景：創傷性關節炎一旦髮生，關節的退變過程將不可避免。在中度以下的肘關節僵硬臨床治療中，傳統肘關節僵硬鬆解是其首選脩複方法。但是，在極重度肘關節僵硬患者臨床治療中的療效存在著諸多的爭議，其矛盾焦點在于傳統肘關節僵硬鬆解實施後關節麵的損傷。<br> 目的：觀察切開鬆解聯閤鉸鏈式外固定支架對極重度肘關節僵硬患者的脩複效果。<br> 方法：選取韶關市粵北人民醫院骨三科2012年5月至2014年7月收治的52例極重度肘關節僵硬患者為研究對象，在醫院倫理委員會批準、所有患者知情下分為對照組與研究組各26例，對照組採用傳統肘關節僵硬鬆解方案進行治療，研究組採用切開鬆解聯閤鉸鏈式外固定支架進行治療，比較兩組患者肘關節屈伸活動度和Mayo肘關節功能評分變化情況。<br> 結果與結論：研究組患者通過採用切開鬆解聯閤鉸鏈式外固定支架進行治療，術後功能評定優良率為96%，肘關節屈伸活動度為(117.5±20.5)°，Mayo肘關節功能評分為(88.5±11.5)分；與對照組77%、(93.5±18.5)°、(76.5±9.5)分相比，差異有顯著性意義(P <0.05)。提示切開鬆解聯閤鉸鏈式外固定支架能夠顯著改善極重度肘關節僵硬患者的肘關節功能，且利于術後康複鍛煉活動開展，具有較高的臨床應用價值。
배경：창상성관절염일단발생，관절적퇴변과정장불가피면。재중도이하적주관절강경림상치료중，전통주관절강경송해시기수선수복방법。단시，재겁중도주관절강경환자림상치료중적료효존재착제다적쟁의，기모순초점재우전통주관절강경송해실시후관절면적손상。<br> 목적：관찰절개송해연합교련식외고정지가대겁중도주관절강경환자적수복효과。<br> 방법：선취소관시월북인민의원골삼과2012년5월지2014년7월수치적52례겁중도주관절강경환자위연구대상，재의원윤리위원회비준、소유환자지정하분위대조조여연구조각26례，대조조채용전통주관절강경송해방안진행치료，연구조채용절개송해연합교련식외고정지가진행치료，비교량조환자주관절굴신활동도화Mayo주관절공능평분변화정황。<br> 결과여결론：연구조환자통과채용절개송해연합교련식외고정지가진행치료，술후공능평정우량솔위96%，주관절굴신활동도위(117.5±20.5)°，Mayo주관절공능평분위(88.5±11.5)분；여대조조77%、(93.5±18.5)°、(76.5±9.5)분상비，차이유현저성의의(P <0.05)。제시절개송해연합교련식외고정지가능구현저개선겁중도주관절강경환자적주관절공능，차리우술후강복단련활동개전，구유교고적림상응용개치。
BACKGROUND:Once traumatic arthritis appears, degeneration of the joints wil be inevitable. In the clinical treatment of moderate or less stiff elbow, traditional elbow stiffness release is the preferred repair method. However, its therapeutic effect is controversial in the clinical treatment of very severe elbow stiffness. The focus on conflict is articular surface damage after the implementation of the traditional release of elbow stiffness. <br> OBJECTIVE: To observe the repair effect of open release combined with hinged external fixator on extremely severe elbow stiffness. <br> METHODS:A total of 52 patients with extremely severe elbow joint stiffness were selected from the Third Department of Orthopedics, Yuebei People’s Hospital from May 2012 to July 2014. Al patients signed the informed consent. In accordance with the approval of Hospital Ethics Committee, they were divided into control and study groups (n=26). Control group received the traditional elbow stiffness release. Study group received open release combined with hinged external fixator. The changes in flexion-extension range-of-motion and Mayo elbow joint function score were compared between the two groups. <br> RESULTS AND CONCLUSION:After treatment with open release combined with hinged external fixator, significant differences in excelent and good rate, range-of-motion of flexion-extension and Mayo elbow joint function score were detected between the study group [96%, (117.5±20.5)°, (88.5±11.5) points] and the control group [77%, (93.5±18.5)°, (76.5±9.5) points] (P < 0.05). These results indicated that open release combined with hinged external fixator significantly improved elbow joint function in patients with extremely severe elbow stiffness, facilitated postoperative rehabilitation exercise activities, and had high value of clinical application.
