摘要
目的：探讨抗滑移钢板治疗肱骨远端 B3型骨折的手术方法和效果。方法自2010年1月至2013年6月,我科应用抗滑移钢板治疗17例肱骨远端 B3型骨折患者,按 AO 分型：B3.1型10例,B3.3型7例,全部采用肘关节外侧入路,术中应用抗滑移钢板结合3.0 mm HCS 无头空心钉固定。结果所有患者均获得随访,术后随访时间6~12个月,平均8个月。无感染和血管、神经损伤,无骨化性肌炎发生,骨折完全愈合。肘关节活动度：伸10°,屈110°,Broberg-Morrey 标准评分平均为90.5分,优良率88.2%。结论应用抗滑移钢板结合 HCS 治疗肱骨远端 B3型骨折,可以获得牢固而有效的固定,允许早期功能锻炼,能达到满意临床效果。
Background Coronal fracture of distal humerus is a rare intra-articular injury involving the articular surface of capitellum and trochlea,and it accounts for approximately 0.5%-1.0% of the fractures of elbow. Fractures of this type are easily missed. Numerous surgical approaches and types of internal fixation have been reported in literatures,but no conclusions are formed.From January 2010 to June 2013,1 7 patients with type B3 fractures of distal humerus were surgically treated with anti-glide plates and 3.0 mm HCS headless cannulated screws through lateral elbow approach to investigate the operative methods and their outcomes.Methods (1 )General information:From January 2010 to June 2013,1 7 patients with type B3 fractures of distal humerus were surgically treated with anti-glide plates,including 9 male and 8 female.The age ranged from 25-71 years and the average age was 42.1 years.Nine cases fractured in left side and 8 cases in right side. Causes of injury:fall from body height in 13 cases,motor accident in 3 cases and fall from meters high in 1 case.All patients were closed injury with no nerve or vascular damage.According to the AO classification,ten cases were type B3.1 fracture and seven were type B3.3.Through the lateral elbow approach,anti-glide plates combined with 3.0 mm HCS headless cannulated screws were used after anatomical reduction.The operation time from injury were 3-4 d.(2 )Operative methods:After successful brachial plexus block or general anesthesia,the patient was placed in supine position with pneumatic tourniquet applied.An incision of about 8 cm was made from 5 cm proximal to the lateral epicondyle of humerus,along the lateral humerus downward across epicondyle to the level of radial head.After each layer was opened,the muscular layer was dissected between the extensor carpi radialis muscle and extensor digitorum muscle.The carpi radialis muscle origin was reflected and the lateral elbow joint capsule was incised from proximal to distal to expose the capitellum and trochlea. Intra-artic
出处
《中华肩肘外科电子杂志》
2014年第3期163-167,共5页
Chinese Journal of Shoulder and Elbow(Electronic Edition)
关键词
肱骨骨折
远端
内固定
抗滑移钢板
Humeral fractures,distal
Internal fixation
Anti-glide plate
