中国骨伤2011，Vol.24Issue(6)：474-478,5.DOI:10.3969/j.issn.1003-0034.2011.06.010
综合疗法预防肘部骨折手术后肘关节僵硬的病例对照研究
Case-control study on combined therapy for preventing postsurgery stiffness after elbow fracture
摘要
Abstract
Objective:To research the efficacy,security and necessity of combined therapy for preventing postsurgery stiffness after elbow fracture. Methods: From May 2009 to April 2010,60 patients with elbow fractures treated by operation were randomly divided into two groups:combined therapy group and past procedure group. Thirty patients in the combined therapy group,including 12 males and 18 females,ranging in age from 23 to 63 years,averaged(43.53±7.74) years old; 15 patients had two parts fractures, including humeral intercondylar fractures combined with olecroanon and (or) ulna coronoid process fractures in 8 cases, fractures of exterior and interior humeral condyle combined with capitulum radius in 3 cases, fractures of olecroanon and ulna coronoid process in 3 cases,fractures of olecroanon and capitulum radius in 1 case;other 15 patients had one part fractures,including fractures of exterior or interior humeral condyle in 8 cases, fractures of olecroanon or ulna coronoid process in 6 cases, fractures of capitulum radius in 1 patient. Thirty patients in the past procedure group, including 11 males and 19 females, ranging in age from 24 to 67 years, averaged (46.13 ±6.22) years; 15 patients had two parts fractures,including fractures of humeral intercondylar fracture combined with olecroanon and(or) ulna coronoid process in 7 cases,fractures of exterior and interior humeral condyle combined with capitulum radius in 2 cases,fractures of olecroanon and ulna coronoid process in 5 cases,fractures of humeral intercondylar fracture combined with capitulum radius in 1 patient; 15 patients had one part fracture, including fractures of exterior or interior humeral condyle in 6 cases, fractures of olecroanon or ulna coronoid process in 8 cases,fractures of capitulum radius in 1 patient;the patients in the past procedure group were treated with past procedure methods. Mayo Elbow Performance Score (including gmotion of elbow joint) and security (using X-ray to recheck displacement fracture,internal fixation failure and heterotopic ossification)were evaluated at postoperative 6 months.From 2002 to 2006,30 patients were reviewed as historical control group,including 17 males and 13 females,ranging in age from 27 to 62 years,averaged (47.17±7.83)years; 15 patients had two parts fractures,including fractures of humeral intercondylar combined with olecroanon and(or) ulna coronoid process in 7 cases ,fractures of exterior and interior humeral condyle combined with capitulum radius in 1 case, fractures of olecroanon and ulna coronoid process in 6 cases, fractures of ulna coronoid process and capitulum radius in 1 case; 15 patients had one part fractures,including fractures of exterior or interior humeral condyle in 9 cases ,fractures of olecroanon or ulna coronoid process in 5 cases ,fractures of capitulum radius in 1 case.The Mayo Elbow Performance Score of the patients in historical control group was evaluated retrospectively at postoperative 6 months and the results were compared with that of past procedure group. Results: Mayo score of combined therapy group was (91.00±7.81)surpassed to (76.83±10.71)of the past procedure group and (73.17±11.99)of historical control group (F=24.98,P＜0.05 ).The range of motion of elbow was (102.40±9.16)degrees of combined therapy group surpassed to (83.57±6.21)degreesof the past procedure group(t=9.325 ,P＜0.05 ). There were no internal fixation loose ,obvious fracture displacement and heterotopic ossification in each X-ray examination of patients in the combined therapy group. The Mayo score of historical control group was (73.17± 11.99), showing no significant differences when compared with (76.83 ± 10.71 ) of the past procedure group (LSD, P=0. 172). Conclusion:Combined therapy including different stage, different method combination and different subject to practice to prevent postsurgery stiffness after elbow fracture is effect, security and necessity.关键词
肘关节/骨折/手术后并发症/综合疗法/病例对照研究Key words
Elbow joint/ Fractures/ Postoperative complications/ Combined modality therapy/ Case-control study引用本文复制引用
李琪,林光锚,李豹,杨国敬,胡顺富,马江燕,林瑞新,蔡春元,刘敏..综合疗法预防肘部骨折手术后肘关节僵硬的病例对照研究[J].中国骨伤,2011,24(6):474-478,5.基金项目
浙江省中医药科学研究基金计划(编号:2010ZB140) （编号:2010ZB140）
