摘要
目的探讨三种肘后入路术式治疗肱骨髁间骨折的效果。方法2000年2月—2006年6月,我院对49例肱骨髁间骨折的患者,按AO分型属B型27例,C型22例,随机采用三种肘后入路术式(传统人路、尺骨鹰嘴截骨和经肱三头肌腱尺骨鹰嘴处入路)进行治疗。结果术后肘关节功能按JOA标准评定:优35例(35/49),占71.4%;良12例(12/49),占24.5%;一般2例(2/49),占4.1%。其中传统手术入路者术后功能的优良率明显低于其余2种手术入路。结论三种肘后入路对肱骨近端都能充分暴露,但采用传统入路术式者术后功能恢复欠佳,且产生医源性并发症的概率较高。尺骨鹰嘴入路是最佳手术入路,但对惧怕尺骨鹰嘴截骨者亦可采用经肱三头肌腱尺骨鹰嘴处入路,二者都能获得良好的疗效,且医源性并发症的发生率较低。
Objective To evaluate the outcomes and complications of three kinds of posterior approach procedure used in the treatment of intercondylar fractures of the humerus. Methods Forty-nine patients with humeral intercondylar fractures were surgically treated from February 2000 to June 2006 in our department. The series involved 33 males and 16 females, whose ages ranged from 17 to45 years （mean 29.5 years）. According to AO classification, 27 cases were of type B and 22 were of type C. Three different posterior approaches were chosen randomly to treat the fractures. Those included conventional posterior approach, olecranon esteotomy approach and triceps splitting approach. Postoperatively the function of the elbow joint was evaluated using JOA criteria and the results compared among the groups. Results Overall 35 eases were rated as excellent aceounting for 71.4% （35/49） of the series. Good results were seen in 12 cases （24.5%, 12/49） and fair results in 2 cases （4.1%, 2/49）. The rate of excellent and good results of cases treated with conventional posterior approach was obviously lower than that obtained by the other two approaches. Conclusions All three kinds of approaches can achieve good exposure of the proximal humerus. Conventional approach procedure leads to less ideal functional recovery and is accompanied with higher complication rate. Olecranon osteotomy provides the best exposure but is associated with possible nonunion of the olecranon. Triceps splitting approach is comparable in regards of good treatment outcome and low complication rate.
出处
《中华手外科杂志》
CSCD
北大核心
2007年第6期342-344,共3页
Chinese Journal of Hand Surgery
关键词
肱骨骨折
外科手术
治疗结果
Humeral fractures
Surgical procedures,operative
Treatment outcome
