中文摘要：

目的探讨创伤性肘关节僵硬患者围手术期护理及康复治疗要点。方法 2010年1月至2014年12月,北京大学人民医院创伤骨科采用开放式肘关节松解结合铰链式外固定架治疗创伤性肘关节僵硬患者8例。非常严重僵硬(活动范围≤30°)2例,严重僵硬(活动范围30°~60°)6例。Mayo肘关节功能评分45~75分,平均53.8分。其中3例患者术前合并尺神经卡压症状。术前开始给予心理护理;术后给予患肢伤口护理、疼痛护理、外固定架针道护理及针对性功能锻炼治疗。结果8例患者均得到11~61个月随访,平均随访时间35.4个月。患者肘关节活动度平均105°。Mayo评分70~95分,平均85.0分。3例患者合并尺神经卡压中的2例尺神经损伤症状完全缓解,1例残留部分手内在肌萎缩。所有8例患者均无肘关节不稳定现象,术后未出现其他并发症。结论采用开放式肘关节松解结合铰链式外固定架治疗创伤性肘关节僵硬,要严格辅助围手术期各项护理及康复治疗,可以有效改善肘关节活动范围,可促进肘关节功能恢复。

英文摘要：

Background The elbow joint is a composite joint consisted of the humeroulnar joint , humeroradial joint ,and proximal radioulnar joint .The causes for elbow joint stiffness include joint capsule scar contracture ,ectopic ossification around the joint and long‐term immobilization .The conservative treatment can be applied to early elbow joint stiffness .The open elbow release surgery is applicable for patients who do not respond to conservative therapy .Although satisfactory range of motion is obtained after complete release ,the loss of range of motion may occur again if the patients don′t exercise due to pain .The assistance of hinged external fixator helps to prevent joint capsule scar contracture ,promote early function exercise ,and effectively prevent relapse of elbow joint stiffness .In this study ,we reported the perioperative nursing care and rehabilitation in 8 cases who presented good outcomes after open release surgery combined with hinged external fixator for traumatic elbow joint stiffness in the department of traumatic orthopedics in the Peking University‐affiliated People′s Hospital from January 2010 to March 2014 .Methods General data:8 cases including 3 males and 5 females with a mean age of 38 .3 years ranged from 17‐61 years were included in the group .4 cases had primary injury caused by dislocation of elbow joint .1 case had radial head fracture .1 had supracondylar fracture of humerus .2 had intercondylar fracture .The time from the initial injury to the surgery ranged from 10‐36 months ,with a mean of 18 .2 months .According to Morrey classification of elbow joint stiffness ,2 cases had very severe stiffness (range of motion ≤30°);6 cases had severe stiffness (range of motion 30°‐60°) .According to Mayo scale for elbow function ,the score ranged from 45‐75 ,with a mean of 53 .8 .Three cases of them had complicated entrapment of the ulnar nerve .Surgery method:All patients of the group were subject to general anesthesia .The surgery with medial and lateral approaches wer