成人肱骨远端关节内粉碎性骨折的治疗

Treatment of intra-articular distal humeral comminuted fracture in adults

目的探讨成人肱骨远端关节内粉碎性骨折的治疗方法。方法采用钢板、螺钉或结合克氏针等内固定治疗成人肱骨远端关节内粉碎性骨折患者，对随访资料完整的24例治疗结果进行分析。结果24例随访时间4-47个月。所有骨折均愈合，愈合时间8-28周，肘关节平均活动范围为15°（伸）→←123°（屈）。按Jupiter标准进行功能评定：优14例，良5例，可3例，差2例。结论肱骨远端关节内骨折根据骨折类型、移位程度选择合适手术入路，早期手术、解剖复位和合理稳定内固定，术后早期功能锻炼，可取得满意疗效。

Objective To study the treatment of intra-articular distal humeral comminuted fracture in adults. Methods 24 adult patients with complete clinical data were followed up. All of the intra-articular distal humeral comminuted fractures were treated with plates and screws or combination of Kirschner wires, the functional outcome of fixation of displaced intra-articular distal humeral fractures were analyzed. Results 24 patients were followed up for 4 - 47 months,averaged 19 months. All fractures united by range 8 - 28 weeks. The final range of motion of the elbow joint was flexion contracture of 15 degnee to further flexion of 123 degnee on average. Functional results were excellent in 14 cases, good in 5 ,fair in 3 ,and poor in 2 according to Jupiter＇s criteria. Conclusion The satisfied effect of treatment of intra-articular distal humeral comminuted fracture in adults can be obtained as long as judging the fracture pattern exactly, choosing a suitable operative approach based on the degree of comminution and displacement of fracture, early operation, anatomical reduction, reasonable stable internal fixation, and early postoperative mobilization.