双钢板内固定急诊手术治疗复杂肱骨远端骨折

Dual plating internal fixation for the emergency surgery of complex distal humeral fractures

目的探讨复杂肱骨远端骨折（肱骨髁间加髁上骨折）应用经尺骨鹰嘴截骨入路，行双钢板内固定急诊手术的疗效。方法急诊手术治疗复杂肱骨远端骨折47例患者，取鹰嘴旁肘后轻度弧形正中切口，经尺骨鹰嘴截骨入路，行切开复位双钢板内固定急诊手术，术后早期功能锻炼。结果全部患者随访5～50个月，平均18个月，骨折在3～6个月全部愈合。采用Cassebaum评分系统评定肘关节功能，优36例，良4例，可5例，差2例，优良率85．1％.结论复杂肱骨远端骨折，应用经尺骨鹰嘴截骨入路，双钢板坚强内固定急诊手术，可以早期进行肘关节功能锻炼，最大限度恢复肘关节功能，在临床可取得满意疗效。

Objective To investigate the efficacy of dual plating internal fixation with oleeranon os teotomy approach for the emergency surgery of complex distal humeral fractures （intercondylar and supracondylar fracture）. Methods Forty-seven cases of complex distal humeral fractures were treated with emergency surgery from May 2002 to May 2007. The dual plating internal fixation was implemented with olecranon osteotomy approach in a postcubital slight arc shaped median incision. Early postoperative rehabil- itation was necessary. Results The follow-up period differed from 5 to 50 months, averaged 18 months. All fractures healed in 3-6 months after surgery. The Cassebaum scoring system was used for the assessment of cubital joint function, 36 cases were exceUent,4 cases were good,5 cases were common, and 2 cases were bad. The excellent and good rate was 85.1%. Conclusions For complex distal humeral fractures, dual plating internal fixation emergency surgery with olecranon osteotomy approach ensures the early postoperative rehabilitation of the cubital joint and the maximum possible functional recovery. It shows the efficacy is satisfactory.