肘关节屈伸功能障碍的治疗

肘关节损伤后，屈伸功能障碍，治疗困难。采用外侧经路，剥离前关节囊附着点，松解肘关节粘连，或经尺骨鹰嘴截骨经路，彻底暴露肘关节，松解肘关节前后粘连，整修关节面，或同时纠正关节面移位，并内固定，取得良好的结果。本组随访４４例，平均年龄３５．６岁，手术距损伤时间平均６．６个月，随访平均２９．８个月。术前肘关节平均屈曲８４．４°，伸肘障碍５０．５°，屈伸范围３０．３°。术后，平均屈曲活动１１３．９°，伸肘障碍１４°。术后肘关节屈伸范围９９．９°，即比术前增加屈伸范围６９．６。２１例关节内骨折引起的肘关节粘连，术前平均屈伸活动２９．７°，术后平均活动范围增加７２．６°。７例肱骨髁间粉碎性骨折，术前肘关节平均屈伸活动４１．４°，术后平均屈伸活动９８．６°，即增加５７．２°。

Treatmenmt of Flexion-Extension Dysfunction of the Elbow

The Treatment of post-traumatic flexion-extension dysfunction of elbow is very difficulty.The lateral approach had be used to detach the contracture of the anterior part of the elbow capsule and to release anterior adhesion.Sometimes the olecranon osteotomy approach is used for exposure elbow thoroughly to release posterioranterior adhesion of elbow and fracture reduction with internal fixation.We had followed-up average 39.8months of 44 patients.The preoperative average flexion deformity of elbow angle was 50.5 degrees and average flexion-extension movement was 30. 3 degrees.After operation the average flexion-extension movement was 99.9 degrees and flexion deformity was reduced to 14 degrees.So the total range of motion of the elbow was improved 69.6 degrees.Twenty-one patients had intra-articular fracture with adhesion of elbow.The preoperative average fiexion-extension movement was 29.7 degrees.After release of adhesion the movement increased to 72.6 degrees.Even the movement of 7 cases who suffered from the intercondylar fracture of the humerus also improved 57.2 degrees after operation.