关节镜松解术与开放式松解术治疗肘关节僵硬疗效比较

目的比较关节镜松解术与开放式松解术治疗肘关节僵硬的临床效果。方法从获得随访的肘关节僵硬患者中分别随机选取22例接受关节镜松解术及22例接受开放式松解术的患者,进行回顾性研究。根据关节活动度(ROM)及Mayo肘关节功能评分标准,比较两组术后关节活动度差异和患肘功能康复情况。结果关节镜松解组获得18～52(28.7±2.5)个月随访,11例术前ROM<50°的患者术后ROM增加62.7°±15.5°;11例术前ROM>50°的患者术后ROM增加48.6°±26.8°。开放式松解组获得12～49(23.5±3.0)个月随访,12例术前ROM<50°的患者术后ROM增加85.8°±28.9°;10例术前ROM>50°的患者术后ROM增加41.5°±19.0°。结论开放式松解术和关节镜松解术治疗肘关节僵硬均安全有效。术前ROM<50°患者采用开放式松解术后可获得更好的肘关节活动度和功能康复;而术前ROM>50°的患者结果则相反。

Comparison of the effects of the open arthrolysis and arthroscopic arthrolysis in treating elbow stiffness

Objective To compare the effects of the open arthrolysis and arthroscopic arthrolysis in treating elbow stiffness.Methods 22 patients treated with open arthrolysis and the other 22 patients treated with arthroscopic arthrolysis,who were randomly choosed from the elbow stiffness patients followed up,were studied in retrospect.The effects of the open arthrolysis and arthroscopic arthrolysis in treating elbow stiffness were compared,according to ROM and Mayo elbow performance score standard.Results The patients of arthroscopic arthrolysis group were followed up for 18 to 52 months,average(28.7±2.5) months.The ROM of 11 patients with the postoperative ROM less than 50 increased by 62.7°±15.5° after surgery,and the ROM of the other 11 patients with the postoperative ROM less than 50 increased by 62.7°±15.5° after surgery;The patients of open arthrolysis group were followed up for 12 to 49 months,average(23.5±3.0) months.The ROM of 12 patients with the postoperative ROM less than 50 increased by 85.8°±28.9° after surgery,and the ROM of the other 10 patients with the mean postoperative ROM less than 50 increased by 41.5°±19.0° after surgery.Conclusions The open arthrolysis and arthroscopic arthrolysis are safe and effective in treating elbow stiffness.For those of patients with the postoperative ROM less than 50,open arthrolysis provides a greater elbow joint′s range of motion and functional rehabilitation compared to the arthroscopic arthrolysis;On the contrary,for those of patients with the postoperative ROM more than 50,the arthroscopic arthrolysis provides a greater elbow joint′s range of motion and functional rehabilitation compared to the open arthrolysis.