Open release combined with hinged external fixator repairs extremely severe elbow stiffness

doi:10.3969/j.issn.2095-4344.2015.04.015

Abstract

Abstract:

BACKGROUND: Once traumatic arthritis appears, degeneration of the joints will 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.

OBJECTIVE: To observe the repair effect of open release combined with hinged external fixator on extremely severe elbow stiffness.

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. All 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.

RESULTS AND CONCLUSION: After treatment with open release combined with hinged external fixator, significant differences in excellent 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.

中国组织工程研究杂志出版内容重点：人工关节；骨植入物；脊柱；骨折；内固定；数字化骨科；组织工程

全文链接：

Key words: Elbow Joint, External Fixators, Joint Capsule Release

CLC Number:

R318

Liu Sheng-ping, Liu Guo-qiang. Open release combined with hinged external fixator repairs extremely severe elbow stiffness[J]. Chinese Journal of Tissue Engineering Research, 2015, 19(4): 578-583.

Figures/Tables 2

2.1 参与者数量分析按意向性处理，所有参与本研究的52例极重度肘关节僵硬患者均按照修复方案内容顺利完成治疗，在修复过程中并未出现脱落病例。本研究所取得的资料数据均来自于临床研究，结果真实有效。 2.2 基线资料比较 52例患者经本院伦理委员会批准、所有患者知情下分为对照组与研究组各26例，两组患者性别、年龄、原始损伤类型、临床病症，一般资料差异经统计学处理差异无显著性意义(P > 0.05)，具体比对情况详见表1所示。 2.3 两组患者术后功能比较本研究中研究组患者采用切开松解联合铰链式外固定支架治疗，术后功能评定优良率96%，与对照组77%相比较，差异有显著性意义，详见表2所示。同时研究组患者尺神经症状显著改善，大部分患者对该修复效果比较满意。 2.4 肘关节屈伸活动度、Mayo肘关节功能评分比较研究组患者经切开松解联合铰链式外固定支架治疗后，肘关节屈伸活动度、Mayo肘关节功能评分与对照组相比较，差异均有显著性意义，具体情况详见表3所示。 2.5 典型病例本研究中1例女性患者右侧肘关节屈伸活动度为10°，是典型的极重度肘关节僵硬患者(肘关节活动度<30°)，通过采用切开松解联合铰链式外固定支架进行治疗，术后随访1年，该患者肘关节功能恢复正常。其治疗前后肘关节活动功能比较详见图2所示。 2.6 不良事件本研究中研究组患者在应用切开松解联合铰链式外固定支架进行修复过程中共发生2例由于医疗器械材质问题所引发的生物兼容性不良事件，其主要表现为肘关节具有中毒疼痛感并在固定部位出现感染现象，为了确保患者临床治疗效果，改用其他材质的外固定支架并对感染现象使用抗生素对症治疗，患者症状消失，具备了继续治疗的条件。 "

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