Post-traumatic elbow stiffness is common in clinic, which usually means that elbow flexion and extension can't reach 30 ~ 65438+030, and rotation can't reach 65438+000 (50 pronation and 50 supination respectively). Stiffness of elbow joint makes the patient's elbow joint unable to move normally, accompanied by pain, which brings great inconvenience to the patient's daily life.
With the continuous development of medical technology, the research on post-traumatic elbow stiffness is getting deeper and deeper. Some research reports point out that the main causes of elbow joint stiffness are: (1) trauma destroys the surface of elbow joint, which makes elbow joint stiff; Soft tissue around the elbow joint is damaged, which makes the elbow joint stiff; Neglect of injury after injury leads to contraction of collateral ligament and joint capsule, and finally leads to stiffness.
According to the classification of etiology, elbow joint stiffness can be divided into extraarticular stiffness, intra-articular stiffness and mixed stiffness. Extraarticular stiffness includes skin and muscle contracture, ligament and joint capsule fibrosis and heterotopic ossification; Intra-articular stiffness includes articular cartilage destruction, intra-articular free body, intra-articular adhesion, fracture abnormal healing and so on. Contraction of joint capsule, ligament and muscle secondary to intra-articular stiffness is called mixed stiffness.
It is a series of problems to improve the mobility of elbow joint, maintain the stability of elbow joint after operation, reduce the incidence of infection and relieve neurological symptoms. Treatment can be roughly divided into two categories: non-surgical treatment and surgical treatment. Non-surgical treatment includes: joint rehabilitation exercise, Chinese medicine fumigation, massage, small needle knife treatment and so on. Surgical treatment was given to those who had poor results in non-surgical treatment, including simple external fixation stent release, arthroscopic release, open release and open release combined with external fixation stent treatment. In our department, a group of patients with extremely severe elbow stiffness were treated by open reduction combined with hinged external fixator, and good results were achieved. The key to successful treatment is to find out the causes of elbow joint stiffness and analyze the types of elbow joint stiffness. The cooperation and persistence of patients and the choice of surgical approach are also very important.