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Sumon Nandi Steven Maschke Peter J. Evans Jeffrey N. Lawton 《Hand (New York, N.Y.)》2009,4(4):368-379
Elbow motion is essential for upper extremity function to position the hand in space. Unfortunately, the elbow joint is prone
to stiffness following a multitude of traumatic and atraumatic etiologies. Elbow stiffness can be diagnosed with a complete
history and physical exam, supplemented with appropriate imaging studies. The stiff elbow is challenging to treat, and thus,
its prevention is of paramount importance. When this approach fails, non-operative followed by operative treatment modalities
should be pursued. Upon initial presentation in those who have minimal contractures of 6-month duration or less, static and
dynamic splinting, serial casting, continuous passive motion, occupational/physical therapy, and manipulation are non-operative
treatment modalities that may be attempted. A stiff elbow that is refractory to non-operative management can be treated surgically,
either arthroscopically or open, to eliminate soft tissue or bony blocks to motion. In the future, efforts to prevent and
treat elbow stiffness may target the basic science mechanisms involved. Our purpose was to review the etiologies, classification,
evaluation, prevention, operative, and non-operative treatment of the stiff elbow. 相似文献
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Mark Sisco MD ; Jerome D. Chao MD ; Injoong Kim MD ; Jon E. Mogford PhD ; Tanya N. Mayadas PhD ; Thomas A. Mustoe MD 《Wound repair and regeneration》2007,15(4):566-571
The Mac-1 integrin is an important mediator of migration and inflammatory activation of neutrophils and monocytes. However, the role of Mac-1 in modulating macrophage emigration and activation and its subsequent impact on cutaneous wound healing have not been fully elucidated. To examine the significance of Mac-1 to murine wound healing, we measured epithelialization and granulation tissue formation in partial-thickness ear wounds and full-thickness head wounds, respectively, in Mac-1-deficient mice. Wounds were histologically analyzed at postwounding days 3, 5, and 7. The gap measured between the leading edges of inward-migrating granulation tissue was significantly increased in knockout mice compared with control animals at day 5 (3.8+/-0.3 vs. 2.6+/-0.5 mm; p<0.001) and day 7 (2.2+/-0.4 vs. 0.96+/-0.73 mm; p=0.005). Epithelial gap measurements were also increased in knockout mice vs. wild-type controls at days 3 (0.62+/-0.02 vs. 0.54+/-0.07 mm; p<0.05) and 5 (0.58+/-0.06 vs. 0.39+/-0.08 mm; p<0.001). Immunohistochemistry showed equal numbers of macrophages in knockout and control wounds. These findings show that Mac-1 is required for normal wound healing but that the attenuation in the deposition of granulation tissue and wound epithelialization in Mac-1 knockout mice is not associated with decreased monocyte migration into the wound. 相似文献