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目的 探讨内侧过顶入路治疗创伤性肘关节僵硬的临床效果.方法 自2011年6月至2014年6月,我们共收治创伤后肘关节僵硬患者15例,其中8例存在肘关节周围异位骨化.均采用内侧过顶入路进行肘关节松解,其中3例因外侧存在异位骨化而采用内外侧联合入路.术后测量肘关节活动度及Mayo评分法对治疗效果进行评定.结果 术后随访时间为9～24个月,平均17.8个月,术后无伤口感染、异位骨化复发、再骨折等并发症发生.2例术后出现切口下积液,2例出现尺神经麻痹.术后肘关节伸直增加角度为25.3°±12.5°,屈曲增加角度为31.7°±14.6°,伸屈活动度为97.4°±13.1°,较术前显著提高(P＜0.001).术后Mayo评分较术前明显提高(P ＜0.001),其中优8例,良5例,可2例.结论 内侧过顶入路松解肘关节僵硬具有创伤较小、松解彻底、方便处理尺神经等优点,特别适用于屈曲挛缩的肘关节僵硬.“,”Objective To investigate the clinical outcomes of treating post-traumatic stiff elbow through the medial “over-the-top” approach.Methods From June 2011 to June 2014, 15 patients with post-traumatic elbow stiffness were treated in our department via the medial “over-the-top” approach to release the elbow.Heterotopic bone formation was found in 8 cases.Among them, 3 had heterotopic bone on the lateral side of the elbow which required a lateral and medial combined approach.To evaluate the results, we compared preoperative and postoperative elbow motion and the Mayo Elbow Performance Index (MEPI) scores.Results All the patients were follow-up for 9 to 24 months, with an average of 17.8 months.There was no wound infection, refracture, nor recurrence of heterotopic ossification postoperatively.Subcutaneous fluid occurred in 2 cases, while ulnar nerve palsy occurred in another 2 cases.Elbow extension increased 25.3° ± 12.5°, while elbow flexion increased 31.7° ± 14.6°.The range of elbow motion was 97.4° ± 13.1°postoperatively, being significantly greater when compared to preoperative values (P ＜ 0.001).The mean MEPI score improved significantly from 58.3 ± 11.3 preoperatively to 82.5 ± 6.9 postoperatively, with the results rated as excellent in 8 patients, good in 5 patients, and fair in 2 patients.Conclusion Surgical treatment of post-traumatic stiff elbow through the medial “over-the-top” approach is especially suitable for flexion contracture release.This approach is less traumatic, can achieve complete release, and is convenient for handling the ulnar nerve.