外固定支架及开放手术治疗肘关节严重异位骨化疗效分析

目的:探讨外固定支架及开放手术治疗治疗肘关节严重异位骨化的方法及疗效。方法:自2007年9月至2012年9月,对18例(其中男13例女5例,平均年龄33.5岁)创伤后严重异位骨化性肘关节僵硬患者进行开放手术及外固定支架治疗。所有患者均采用相同的手术方式,即取出原有内固定,前置尺神经,松解关节囊粘连,清除异位骨化。对患者肘关节屈伸范围术前及术后均评估,采用Mayo肘关节评分肘关节功能(MEPI)评估疗效。术后予以指导康复锻炼。结果:术后患者的屈伸分别平均增加到125°和10°,MEPI评分由术前的平均50分提高到术后的90分。结论:外固定支架及开放手术治疗治疗严重异位骨化性肘关节僵硬具有确切的疗效。

Clinical Analysis of Treating Elbow Stiffness with Serious Heterotopic Ossification by External Fixator and Open Surgery

Objective:To explore the effectiveness of external fixator and open surgery in treatment of elbow stiffness with serious heterotopic ossification.Methods:This study involved 18 patients with servere elbow heterotopic ossification treated by open surgery and a hinged external fixation between September 2007 and September 2012. There were 13 males and 5 females with average age of 33.5 years. All patients were treated by using the same surgical protocol, including hardware removal, heterotopic ossification excision, circumferential elbow capsulectomy, anterior ulnar nerve transposition, and hinged external fixation. Range of motion (ROM) and Mayo elbow score were measured preoperatively and postoperatively. Rehabilitation was started immediately after surgery.Results:All patients had achieved a functional arc of motion of 100 degrees. The Mayo elbow score improved from a mean of 50 to 90 points.Conclusion:Management of elbow stiffness with serious heterotopic ossification by a hinged external fixator and open arthrolysis is a valuable and effective procedure.