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手术清理联合活动外固定架治疗肘关节创伤后异位骨化的疗效分析
Hits: 1972   Download times: 1572   Received:August 22, 2016    
作者Author单位UnitE-Mail
阎亮 YAN Liang 河南省中医院关节科, 河南 郑州 450002 Department of Joint Surgery, Traditional Chinese Medicine Hospital of Henan Province, Zhengzhou 450002, Henan, China 33946314@qq.com 
赵建磊 ZHAO Jian-lei 河南中医药大学, 河南 郑州 450008  
王上增 WANG Shang-zeng 河南省中医院关节科, 河南 郑州 450002 Department of Joint Surgery, Traditional Chinese Medicine Hospital of Henan Province, Zhengzhou 450002, Henan, China  
冯丽娜 FENG Li-na 河南省中医院关节科, 河南 郑州 450002 Department of Joint Surgery, Traditional Chinese Medicine Hospital of Henan Province, Zhengzhou 450002, Henan, China  
期刊信息:《中国骨伤》2017年30卷,第1期,第5-8页
DOI:10.3969/j.issn.1003-0034.2017.01.001


目的:评价内外侧联合入路手术清理联合活动外固定架对创伤后异位骨化(heterotopic ossification,HO)合并肘关节僵硬患者的临床疗效。

方法:2010年7月至2013年12月,采用肘关节内外侧联合入路松解结合活动外固定架固定治疗HO合并肘关节僵硬患者26例,其中男18例,女8例;年龄14~60岁,平均37.7岁;手术松解距受伤时间7~18个月,平均9.3个月。测量患者术前、术后的肘关节屈伸、前臂旋转角度,并进行Mayo评分。

结果:1例术后3周出现外固定架针孔慢性感染,给予去除外固定架,余所有患者伤口Ⅰ期甲级愈合。26例均获随访,时间24~40个月,平均34个月。1例术后8个月出现2次HO。术后2年所有患者肘关节屈伸活动度、旋转活动度及Mayo评分较术前有明显改善(P<0.05)。

结论:采用肘关节内外侧联合入路松解结合活动外固定架固定治疗创伤后HO合并肘关节僵硬可有效改善肘关节功能,疗效满意。
[关键词]:异位骨化  肘关节  外固定器  肌僵硬
 
Analysis on the effect of surgical cleaning combined with external fixator for the treatment of post-traumatic heterotopic ossification of elbow joint
Abstract:

Objective: To evaluate the clinical efficacy of surgical treatment using a combined medial and lateral approach combined with an external fixator for the treatment of post-traumatic heterotopic ossification (HO) in patients with stiff elbow joints.

Methods: Surgical release using the combined medial and lateral approach combined with external fixation for the treatment of HO and elbow stiffness in 26 patients from July 2010 to December 2013.The study group included 18 males and 8 females, with an average age 38.7 years (ranged 14 to 60 years).The time from injury to surgery averaged 9.3(ranged 7 to 18) months.Before and after operation, the elbow range of motion and forearm rotation angle were measured, and the Mayo Elbow Performance Score (MEPS) was evaluated.

Results: The wound of all patients was well healed during the first period, except one patient who had chronic infection at the external fixation pin 3 weeks after operation.Then the external fixator was removed.All 26 patients were followed up, and the during ranged from 24 to 40 months, with an average of 34 months.HO recurrence occurred in 1 patient 8 months after operation.The range of motion, forearm rotation angle, and Mayo Elbow Performance Score of elbow joint in patients was significantly improved compared with that before surgery (P<0.05).

Conclusion: Surgical release using the combined medial and lateral approach combined with an external fixator for the treatment of traumatic HO and elbow stiffness can effectively improve elbow function, resulting in a satisfactory effect.
KEYWORDS:Heterotopic ossification  Elbow joint  External fixators  Muscle rigidity
 
引用本文,请按以下格式著录参考文献:
中文格式:阎亮,赵建磊,王上增,冯丽娜.手术清理联合活动外固定架治疗肘关节创伤后异位骨化的疗效分析[J].中国骨伤,2017,30(1):5~8
英文格式:YAN Liang,ZHAO Jian-lei,WANG Shang-zeng,FENG Li-na.Analysis on the effect of surgical cleaning combined with external fixator for the treatment of post-traumatic heterotopic ossification of elbow joint[J].zhongguo gu shang / China J Orthop Trauma ,2017,30(1):5~8
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