解剖型钢板治疗肱骨髁间粉碎性骨折

Anatomy plates in therapy of comminuted humeral intercondylar fracture

目的探讨解剖型钢板内固定治疗肱骨髁间粉碎性骨折的疗效。方法对18例成人肱骨髁间粉碎性骨折采用后路经鹰嘴V形截骨、尺神经前置、解剖型钢板内固定,术后早期功能锻炼。均于术后4、10周及6、12个月摄片复查,了解骨折愈合情况。结果随访12-30个月,术后12-18周骨折全部愈合。肘关节功能用改良Cassebaum评分系统评价：优9例,良5例,可2例,差2例。术后尺神经麻痹1例于术后6个月完全恢复;术后5周肘关节异位骨化1例,1例因糖尿病切口延迟愈合。结论解剖型钢板治疗肱骨髁间粉碎性骨折,固定牢靠,术后可早期功能锻炼。

Objective To study the effect of the treatment of comminuted humeral intercondylar fracture with open reduction and internal fixation with anatomy plates. Methods Eighteen patients with comminuted humeral intercondylar fractures were treated with open reduction and internal fixation with anatomy plates after standard posterior approach and ＂ V＂ olecranon osteotomy with anterior transposition of the ulnar never. Early exercises were trained. All of them are followed up with X-ray photograph for 4 weeks, 10 weeks ,6 months and one year after operation. Results The follow-up was from 12 to 30 months, and all the fractures were union. The duration of union was 12 - 18 weeks. According to the modified Cassebaum rating system, the results were excellent in 9 patients, good in 5, fair in 2 and poor in 2. One case of ulnar nerve palsy was recovered in 6 months after operation. Heterotopic ossification around the albow joint was showed in one of the patients at the 5th week after operation. The incision of one patient had delayed union because of diabetes mellitus. Conclusions In the treatments of the comminuted humeral intercondylar fractures with anatomy plates fixation ,the fixation was rigid and the patients could have early functional exercise after operation.