铰链外固定架结合中药外敷手法推拿治疗创伤后肘关节僵硬

目的：探讨铰链外固定架结合中药外敷手法推拿治疗创伤后肘关节僵硬的疗效；方法：2008年7月-2011年12月，对37例肘关节僵硬患者（其中男28例，女9例；年龄24～53岁，平均33．7岁），行切开松解铰链外固定支架固定术，术后配合中药外敷、手法推拿。结果：37例患者术后获平均12．1个月（7～24个月）随访，肘关节平均最大屈曲活动度由术前（60．4±31．10）°改善为术后（101．5±21．10）°，平均最大伸直活动度由术前（35．8±11．10）°，改善为术后（15．6±15．10）°，总平均活动范围由术前（34．2±20．0）°改善为术后（85．9±9．10）°；MEPS评分：术前平均为（70．5±13．3）分，术后平均为（90．6±6．3）分，改善（20．1±17．1）分，术前、术后比较差异均有统计学意义（P〈0．005）。结论：运用铰链外固定架结合中药外敷手法推拿治疗创伤后肘关节僵硬的疗效显著，可有效改善僵硬肘关节的活动功能。

Metal Hinged Elbow External Fixator combined with External Application of Traditional Chinese Medicine and Massage for Treatment of Post-traumatic Elbow Stiffness

Objective：To analyze the effectiveness of hinged external fixator combined with external application of traditional Chinese medicine and manual massage in treating post-traumatic elbow stiffness. Methods：Thirty-seven cases （28 males, 9 females and 33.7 years old on average） of patients with stiff elbow underwent arthrolysis and hinged external fixator combi- ning external application of traditional Chinese medicine and manual massage. Results：The average follow-up time was 12. 1 months （7-24 months）. The maximum angle of flexion improved from preoperative 60.4°4±31.10°to postoperative 101. 5°4- 21.10°, the maximum angle of extension from preoperative 35.8°±11.10° to postoperative 15.6°±15.10°, and the av- erage total range of motion changed from preoperative 34.2°±20.0° to postoperative 85.9°± 9.10°. The MEPS improved from preoperative 70.5 ± 13.3 to postoperative 90.6 ± 6.3. There were significant differences between preoperation and postoperation in all indexes above （P〈 0.05）. Conclusion： Hinged external fixator combined with external application of traditional Chinese medicine and manual massage can obviously improve the function of the post-traumatic stiff elbow.