摘要
目的探讨经肱三头肌两侧入路双柱固定治疗肱骨远端骨折的疗效。方法 2008年10月至2011年10月对16例肱骨远端骨折采用经肱三头肌两侧入路,双接骨板固定肱骨远端内外侧柱,男12例,女4例;年龄17～61岁,平均36岁;右侧11例,左侧5例。损伤机制：摔伤5例,高处坠落伤9例,车祸伤2例。骨折类型：按AO/ASIF分型,A型2例,C型14例,其中C1型8例,C2型6例。受伤至手术时间2～8 d。结果所有病例均获随访,随访时间12～24个月,平均为15个月。所有骨折均愈合,无感染。末次随访时,肘关节平均屈曲度数为125°（95°～140°）,平均屈曲挛缩23°（0°～85°）,前臂旋前平均为70°（40°～80°）,前臂旋后平均为83°（70°～90°）。采用Mayo肘关节评分（mayo elbow performance index,MEPI）,平均为90分（65～100分）,其中优6例,良8例,差2例,优良率为87.5%。2例术后出现尺神经迟发性麻痹。结论对于肱骨远端C1、C2型骨折,经肱三头肌两侧入路能够满足复位固定要求,疗效满意。
Objective To investigate the clinical effect of double-plating fixation in treatment of distal humerus fractures via an extensor mechanism-on approach. Methods From October 2008 to October 2010,16 patients with distal humerus frac-ture were treated with double-plating fixation via an extensor mechanism-on approach. There were 12 males and 4 females,aged from 17 to 61 years（36 years on average）. The dominant extremity was involved in 11 patients. The mechanism of injury in-cluded 5 ground-level falls,9 falls from a height,and 2 motor-vehicle accidents. The fractures were classified according to the AO/ ASIF classification. 2 patients had a type-A fracture,14 had a type-C fracture. Of the type-C fractures,8 were C1,6 were C2. The time interval from the injury to surgery was two days to eight days. All patients were no preoperative ulnar nerve symp-toms. Results The 16 patients were followed-up from 12 to 24 months,with an average of 15 months. All 16 fractures healed primarily without infection. The average final flexionarc was 125°and the average flexion contracture of 23°and the average pro-nation-supination arc was 153°. The mean MEPI was 90 points（65 to 100 points）,with six excellent,eight good,and two fair grades. The excellent and good rate was 87. 5% . Two patients had ulnar nerve dysfunction postoperatively. All elbows were sta-ble at the time of final follow-up. Conclusion Satisfactory functional outcomes can be acquired with the use of the extensor mechanism-on approach for AO-type-C1 and C2 fractures of distal humerus.
出处
《实用骨科杂志》
2014年第9期773-775,813,共4页
Journal of Practical Orthopaedics
关键词
肱三头肌
肱骨远端骨折
双柱固定
tricep
distal humerus fractures
double-plating fixation
