肘关节镜下松解治疗肘关节僵硬的临床疗效

目的 初步探究肘关节镜下松解治疗肘关节僵硬的效果。方法 选取2018年6月1日至2021年5月31日行关节镜下肘关节松解的患者30例，其中男性19例，女性11例，年龄26~65岁，平均（45.6±4.3）岁。按照O'Driscoll四步法对肘关节僵硬进行松解，术后肘关节常规冰敷1周，术后第1天佩戴铰链支具，指导下进行屈伸功能锻炼。记录术前、术后1周、1个月、3个月肘关节的屈伸活动，比较术前与术后3个月患者肘关节活动度（range of motion，ROM）的变化，使用Mayo评分标准评价患肘功能恢复情况。结果 术后随访29例，失访1例，随访9~12个月，平均（10.6±1.4）个月。所有患者术后均未出现神经损伤症状、切口感染、肘关节异位骨化等并发症。肘关节平均最大ROM：术前63.30°±21.20°，术后1周77.82°±13.75°、术后1个月85.52°±11.32°、术后3个月110.19°±10.18°，术后1周、1个月、3个月的平均最大ROM与术前比较，差异均有统计学意义（P<0.05）。肘关节Mayo评分：术前（52.34±14.32）分、术后1周（63.48±10.35）分、术后1个月（73.44±8.77）分、术后3个月（80.43±13.74）分，术后1周、1个月、3个月的肘关节Mayo评分与术前Mayo评分比较，差异均有统计学意义（P<0.05）。结论 肘关节镜下松解治疗肘关节僵硬可改善肘关节活动度，早期促进肘关节功能恢复，利于早期开展功能锻炼和提高临床疗效。

Clinical effect of elbow arthroscopy in the treatment of elbow joint stiffness

Objective To explore the clinical effect of elbow arthroscopic surgery for the treatment of elbow joint stiffness.Methods Thirty patients with elbow stiffness were accepted elbow arthroscopic lysis surgery from Jun 1, 2018 to May 31, 2021, including 19 males and 11 females aged from 26 to 65 years old with an average of (45.6±4.3) years old. All patients underwent elbow arthroscopy to release the stiffness of the elbow joints by the O'Driscoll four-step method, and all operations were operated by one surgeon. Accordingly, the elbow joint was routinely iced for a week after the operation, and the hinge brace was worn on the first day after the operation to guide the flexion and extension exercises.The elbow flexion and extension activities were recorded before operation, 1 week after operation, 1 month after operation, and 3 months after operation, and the changes in range of motion (ROM) of elbow joint in patients before operation and 3 months after operation were compared.The Mayo scoring standard was used to evaluate the recovery of patients' elbow function.Results Twenty-nine cases were followed up after surgery, and 1 case was lost. The follow-up time was 9-12 months, with an average of (10.6 ±1.4) months. All patients had no complications such as nerve injury symptoms, incision infection, and heterotopic ossification of the elbow joint. The average maximum ROM of elbow joint:before operation 63.30°±21.20°, 1 week after operation 77.82°±13.75°, 1 month after operation 85.52°±11.32°, 3 months after operation 110.19°±10.18°, one week after operation compared with the preoperative ROM, the average maximum ROM in 1 week, 1 month and 3 months after operation showed statistically significant differences (P < 0.05).The Mayo scores of elbow joints were as follow:preoperative (52.34±14.32) points, 1 week postoperative (63.48±10.35) points, 1 month postoperatively (73.44±8.77) points, 3 months postoperatively (80.43±13.74) points. The Mayo scores of elbow joints in 1 week, 1 month and 3 months after operation were compared with it before surgery, and the differences were statistically significant (P < 0.05).Conclusion The elbow arthroscopy treatment of elbow joint stiffness can significantly improve the range of motion of elbow joint, promote early functional recovery of the elbow joint, facilitate early functional exercises and improve clinical efficacy.