肱骨髁间粉碎性骨折内固定方法及临床疗效评价

Clinical effect evaluation and internal fixation methods of humeral intercondylar comminuted fracture

目的探讨肱骨髁间粉碎性骨折内固定方法,评价其临床疗效,分析其他相对因素对临床疗效的影响。方法对35例C型肱骨髁间粉碎性骨折患者经尺骨鹰嘴截骨入路或肱三头肌舌形瓣入路,21例行双侧重建钢板,11例行"Y"形钢板,3例行多枚克氏针内固定。结果35例均获随访,时间5个月～4年,骨折全部愈合,应用Aitken和Rorabeer评分系统评价其功能恢复情况,优13例,良11例,可7例,差4例,优良率68.6%。结论双侧重建钢板和Y形钢板能够提供有效坚强内固定。骨折自身创伤严重程度、手术入路选择、术中复位结果、术后功能锻炼,均能影响肘关节功能恢复。

Objective To explore the effects of surgical treatment of humeral intercondylar comminuted fracture with open reduction and internal fixation. Methods 35 patients of humeral intercondylar comminuted fractures were treated with open reduction and internal fixation by way of olecranon osteotomy or Campell＇s. There were 11 cases using Y shaped plates, 21 with double reconstruction plates, and 3 with wires. Results The follow-up observation lasted from 5 months to 5 years. All the fracture healed. The effects were evaluated with Aitken and Rorabeek cassbaum rating system： 13 cases were excellent, 1! good, 7 fair, and 4 cases poor. The excellent and good rate of elbow function was 68.6%. Conclusions Y shaped plate and two double reconstruction plates can provide stable and durable internal fixation. The severity of fracture, reduction, operational method and early function exercises are significant related to the functional recovery of humeral intercondylar fracture.