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首页> 外文期刊>Journal of Hand Surgery. American Volume >Elbow capsulectomy for posttraumatic elbow stiffness.
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Elbow capsulectomy for posttraumatic elbow stiffness.

机译：肘囊切开术用于创伤后肘部僵硬。

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摘要

PURPOSE: To determine factors associated with diminished elbow function and upper-extremity-specific health status after elbow capsulectomy for posttraumatic stiffness. METHODS: Forty-six adult patients with posttraumatic elbow stiffness were evaluated an average of 48 months after open capsular excision. A second capsular excision was performed in 9 patients (29%). Stepwise multiple linear regression analysis was used to identify predictors of the American Shoulder and Elbow Surgeons Elbow Score, the Mayo Elbow Performance Index, and the Disabilities of the Arm, Shoulder, and Hand scores after all procedures. RESULTS: The average improvement in ulnohumeral motion after the index surgery for capsular release was 53 degrees . (The average flexion was 98 degrees .) The 9 patients who had subsequent repeat elbow contracture release gained an additional 24 degrees , leading to a final average flexion arc for the entire cohort of 103 degrees . Multiple linear regression identified the American Shoulder and Elbow Surgeons pain score, persistent ulnar nerve dysfunction, and duration of follow-up evaluation after the initial capsular release as independent predictors of a higher Disabilities of the Arm, Shoulder, and Hand questionnaire score; flexion arc and pain score as independent predictors of the Mayo Elbow Performance Index; and flexion arc, forearm arc, pain score, and persistent ulnar neuropathy as independent predictors of the American Shoulder and Elbow Surgeons score. CONCLUSIONS: Open elbow capsulectomy for posttraumatic elbow stiffness restores a near-100 degrees flexion arc on average. Second elbow releases provide limited additional motion in most patients. Final motion influences physician-based rating scales but not patient-specific health status (Disabilities of the Arm, Shoulder, and Hand questionnaire), which is dominated by pain and persistent ulnar neuropathy. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic IV.
机译：目的：确定创伤后僵硬性肘关节囊切开术后肘功能减弱和上肢特定健康状况的相关因素。方法：对46例成年创伤性肘关节僵硬的成人患者，在开放囊切除后平均48个月进行评估。 9例（29％）患者进行了第二次包膜切除术。使用逐步多元线性回归分析来确定所有步骤后美国肩肘外科医师肘得分，Mayo肘绩效指数以及手臂，肩膀和手部残疾得分的预测因子。结果：荚膜释放指数手术后尺骨肱骨运动的平均改善为53度。 （平均屈曲度为98度。）9例患者随后重复肘部挛缩释放，又获得了24度角，导致整个队列的最终平均屈曲度为103度。多元线性回归确定了美国肩肘外科医师的疼痛评分，持续性尺神经功能障碍和初始包膜释放后的随访评估持续时间是臂，肩和手残障评分较高的独立预测因子;弯曲弧度和疼痛评分是Mayo肘关节性能指数的独立预测因子;屈曲弧度，前臂弧度，疼痛评分和尺神经持续病变是美国肩肘外科医师评分的独立预测指标。结论：创伤后肘部僵硬的开放肘囊切开术平均可恢复近100度的弯曲弧度。第二肘释放在大多数患者中提供了有限的额外运动。最终运动会影响基于医生的评分量表，但不会影响患者特定的健康状况（手臂，肩膀和手部残疾情况调查表），后者主要由疼痛和尺神经持续病变引起。研究类型/证据级别：治疗IV。

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