经肘前入路软骨钉治疗肱骨小头骨折

Treatment of Capitulum Humeri Fractures with Absorbable Cartilage Nail Via Anterior Elbow Approach

目的探讨经肘前人路软骨钉治疗肱骨小头骨折内固定手术的方法和疗效。方法 2008年6月至2011年8月,采用经肘关节前侧"S"形入路可吸收软骨钉内固定治疗肱骨小头骨折12例,男8例,女4例,年龄12～52岁,平均28.5岁,Ⅰ型骨折5例,Ⅱ型骨折3例,Ⅲ型2例,Ⅳ型2例;其中有3例合并有桡骨小头骨折,1例合并有尺骨冠状突骨折。结果随访6～36个月,平均25个月。骨折临床愈合时间4～10周,平均6周。根据Morrey肘关节功能评分标准,良好(满意)9例,一般3例,无骨不连及肱骨小头缺血性坏死发生。结论肘前人路损伤小,暴露清楚,可直视下对肱骨小头的骨折块进行解剖复位;可吸收软骨钉对关节软骨面的损伤小,固定牢靠,可早期进行功能锻炼,无需二次取出,有利于肘关节功能的良好恢复。

Objective To evaluate clinical outcome of internal fixation with absorbable cartilage nail via anterior elbow approach for capitulum humeri fractures. Methods From June 2008 to August 2011,12 patients of capitulum humeri fractures were treated with absorbable cartilage nail via anterior elbow approach. There were 8 males and 4 fe-males with an average age of 28.5 years（range 12-52 years）. 5 cases were type Ⅰ ,3 cases were typeⅡ ,2 cases were type Ⅲ ,2 cases were type IV ,among which 3 cases were merged with radial head fractures, 1 case was merged with ulna coronoid process fracture. Results The patients were followed up for 6 to 36 months. The healing time was 6 weeks in average（range 4-10 weeks）. Morrey scores were good（satisfaction） in 9 cases and general in 3 cases. Bone nonunion and vascular necrosis of capitulum humeri were not found. Coclusion Anterior elbow approach has the ad-vantages of small injury and clear exposure. Capitulum of humerus fracture block can be performed under direct vision anatomical reduction. Absorbable cartilage nail has the advantages of small damage to articular cartilage surface ,firm fixation,early functional exercise can be ,no need to take out ,and helpful to elbow joint function recovery.