【摘要】 目的探讨切开复位锚钉固定治疗肘关节内侧副韧带复合体损伤的临床疗效。方法 2015年3月—2018年2月四川现代医院收治肘关节内侧副韧带复合体损伤患者89例,男性52例,女性37例;年龄20～79岁,平均58.8岁。按治疗方案不同分为非手术组44例和内固定组45例,非手术组采用石膏外固定治疗4～6周后行功能恢复锻炼,内固定组采用切开复位锚钉固定,比较两组患者治疗前及治疗后1、6、12个月肘关节Mayo评分和肘关节活动度、治疗后腱-骨界面愈合时间及并发症发生率。结果两组患者治疗后肘关节功能改善均显著优于治疗前,内固定组治疗后1个月[(73.62±2.35)分vs.(68.95±3.41)分]、6个月[(78.25±2.86)分vs.(73.24±2.51)分]和12个月[(85.33±4.24)分vs.(78.83±3.73)分]肘关节Mayo评分均显著高于非手术组(P<0.05)。治疗后,两组患者肘关节活动度均大于治疗前,内固定组治疗后1个月[(109.52±11.54)°vs.(94.17±10.77)°]、6个月[(118.57±9.49)°vs.(105.52±8.47)°]和12个月[(131.66±7.71)°vs.(121.90±7.39)°]肘关节活动度显著大于非手术组(P<0.05)。与非手术组比较,内固定组患者腱-骨界面愈合时间显著缩短[(9.25±1.28)周vs.(11.46±1.36)周](P<0.05)。内固定组治疗后伤口感染、创伤性关节炎、关节僵硬并发症发生率2.22%较非手术组13.64%显著降低(P<0.05)。结论切开复位锚钉固定对肘关节内侧副韧带复合体损伤具有较好的临床疗效,不仅能改善其肘关节功能,还能降低并发症发生率。更多还原

【Abstract】 Objective To investigate the clinical effect of open reduction and anchor fixation in the treatment of injury of medialaccessary ligament complex of elbow. Methods Totally 89 patients with injury of medialaccessary ligament complex of elbow admitted to Sichuan Modern Hospital from Mar. 2015 to Feb. 2018 were selected. There were 52 males and 37 females aged 20-79 years with an average of 58.8 years. According to the treatment plan,the patients were divided into conservative group(44 cases) and internal fixation group(45 cases). The conservative group received plaster external fixation for 4 to 6 weeks and then performed functional recovery exercises,and the internal fixation group was treated with open reduction and anchor fixation.The Mayo score of elbow joint,elbow motion,healing time of tendon-bone interface and incidence of complications were compared between the two groups before and after treatment. Results The elbow joint function after treatment in both groups was significantly better than that before treatment, and the Mayo score of elbow joint in the internal fixation group was significantly higher than that in the conservative group at 1 month[(73.62±2.35)score vs.(68.95±3.41)score],6 months[(78.25±2.86)score vs.(73.24±2.51)score] and 12 months[(85.33±4.24)score vs.(78.83±3.73)score] months after treatment(P<0.05). After treatment,the elbow joint mobility of the two groups was better than that before treatment. The elbow joint mobility of the internal fixation group was significantly better than that of the conservative group at 1 month [(109.52±11.54) ° vs.(94.17±10.77) °],6 months [(118.57±9.49)° vs.(105.52±8.47) ° and 12 months [(131.66±7.71)°vs.(121.90±7.39)°(P<0.05).Compared with the conservative group[(11.46±1.36)weeks],the tendon-bone healing time in the internal fixation group [(9.25±1.28)weeks] was significantly shorter(P<0.05). The incidence of wound infection,traumatic arthritis and joint stiffness in internal fixation group was 2.22%(1/45),which was significantly lower than 13.64%(6/44) in conservative group(P<0.05). Conlusion Open reduction and anchor fixation have a good clinical effect on injury of medialaccessary ligament complex of elbow. It can not only improve the function of elbow joint,but also reduce the incidence of complications.更多还原