关节挛缩患儿伸肌挛缩的肘关节后侧松解术矫正研究

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背景：关节挛缩患儿缺乏肘部屈曲能力，伴随肘部伸肌挛缩，因此自理能力受限。

目的：本研究旨在分析不同年龄组关节挛缩患儿接受肘关节后侧松解术联合或不联合肱三头肌延长术（Z形或V-Y技术）的治疗效果。

材料和方法：本研究包含了109例关节挛缩伴肘关节（158例关节）伸肌挛缩的患者，这些患者在
2005年至2018年接受了膝关节后侧松解术，以增强膝关节的被动屈曲能力。行临床检查、超声检查和
X线检查。

结果：根据手术年龄和手术矫正方法（联合或不联合肱三头肌延长术），将患儿分为九组。主要研究组（67.1%）术后随访期为4.5年。3岁以下的患儿中，与接受肱三头肌肌腱延长术的患儿（85.56%）
相比，95.83%未肱三头肌延长术的患儿取得了良好疗效。1岁以下患儿在术后的被动运动幅度最大，而肱三头肌肌腱延长（104.00°± 16.24°）病例的术后被动运动幅度超过未行肱三头肌肌腱延长术的病例（91.38°± 10.27°）（p < 0.001）。但未行肱三头肌肌腱延长术的患儿伸展能力受限。
3年间，肱三头肌Z形伸展和V-Y伸展疗效尚可，分别增加至19.44%和36.51%。7岁以上患儿的治疗效
果与3~7岁患儿相当。

结论：接受肘关节后侧松解术后，膝关节被动活动度使关节挛缩患儿能够通过适应性机制照顾自己。后侧关节松解术后膝关节伸肌挛缩的治疗效果不是取决于延长技术（V-Y或Z形），而是取决于肱三头肌肌腱的缝合角度、手术时间和术后康复情况。

作者简介

Ekaterina Petrova

The Turner Scientific Research Institute for Children’s Orthopedics

编辑信件的主要联系方式.
Email: pet_kitten@mail.ru
ORCID iD: 0000-0002-1596-3358
SPIN 代码: 2492-1260

MD, PhD, Senior Research Associate of the Department of Arthrogryposis

俄罗斯联邦, Saint Petersburg

Olga Agranovich

The Turner Scientific Research Institute for Children’s Orthopedics

Email: olga_agranovich@yahoo.com
ORCID iD: 0000-0002-6655-4108

MD, PhD, D.Sc., Supervisor of the Department of Arthrogryposis

俄罗斯联邦, Saint Petersburg

Svetlana Trofimova

The Turner Scientific Research Institute for Children’s Orthopedics

Email: trofimova_sv2012@mail.ru
ORCID iD: 0000-0002-4116-8008

MD, PhD, Research Associate of the Department of Arthrogryposis

俄罗斯联邦, Saint Petersburg

Evgeniia Kochenova

The Turner Scientific Research Institute for Children’s Orthopedics

Email: jsummer84@yandex.ru
ORCID iD: 0000-0001-6231-8450

MD, PhD, Orthopedic and Trauma Surgeon of the Department of Arthrogryposis

俄罗斯联邦, Saint Petersburg

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