[Case-control study on combined therapy for preventing postsurgery stiffness after elbow fracture].

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,P0.05).The range of motion of elbow was(102.40±9.16)degrees of combined therapy group surpassed to(83.57±6.21)degrees of the past procedure group(t=9.325,P0.05).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.