三头肌劈开和尺骨鹰嘴截骨入路治疗肱骨髁间骨折的疗效比较

Comparison of clinical effect of tricepts-split and olecranon osteotomy in treatment of intercondylar humeral fractures

目的 评估采用三头肌劈开和尺骨鹰嘴截骨两种不同入路治疗肱骨髁间骨折的临床效果。 方法 86例肱骨髁间骨折患者均接受切开复位钢板内固定手术,其中 43例采用三头肌劈开入路, 43例采用尺骨鹰嘴截骨入路。 结果 所有患者平均随访 36. 6个月。Mayo肘关节评分、上肢、肩、手功能障碍(disabilitiesofthearm, shoulderandhand, DASH)评分和Knirk等评分显示两组差异无统计学意义(P>0. 05),放射学检查 77例患者临床效果均良好。并发症包括 6例延迟愈合, 1例严重的肘关节僵硬, 2例神经麻痹。 结论 切开复位内固定治疗肱骨髁间骨折安全有效。三头肌劈开入路和尺骨鹰嘴截骨入路均可获得相同的临床效果。

Objective To review clinical outcome of intercondylar humeral fractures treated with tricepts-split and olecranon osteotomy. Methods Open reduction and internal fixation using plates were performed in 86 cases with intercondylar humeral fracture, of which triceps split was carried out in 43 while an olecranon osteotomy in other 43. Results All patients were followed up for a mean (36.6) months (12-141 months). Mayo Elbow Score, Disabilities of Arm, Shoulder and Hand (DASH) questionnaire and scale of Knirk showed no statistical difference (P>0.05). Radiographic analysis showed quite good results in 77 cases. Complications included delayed union in six cases, severe stiffness in one and neuropraxia in two. Conclusions Open reduction and internal fixation of intracondylar humeral fractures is a safe and effective technique. Meanwhile, triceps-split approach and olecranon osteotomy can obtain same clinical outcome for intracondylar humeral fractures.