Y形钢板内固定置入治疗肱骨远端粉碎性骨折18例

Y-shape plate in the treatment of comminuted fractures of the distal humerus among 18 cases

目的:观察Y形钢板内固定置入治疗肱骨远端粉碎性骨折的不良反应及临床疗效。方法:回顾性分析2003-01/2006-12本院收治的肱骨远端粉碎性骨折共18例,分别采用3～7孔左右式Y形钢板内固定治疗,钢板材质为不锈钢及钛合金,观察材料及宿主反应。按改良Cassebaum评分进行疗效评定。定期复查X射线片,观察骨折愈合情况;肢体有无疼痛、关节活动情况。结果:平均手术时间134min,平均术中出血量172mL,切口均Ⅰ期愈合。术后随访6个月,骨折平均愈合时间14周,1例截骨处延迟愈合,2例出现克氏针退出,无感染及局部炎症反应和排异反应。18例患者中,优11例,良4例,可2例,差1例,优良率83.3%。结论:用Y型钢板置入后与人体具有良好的生物相容性,肱骨远端粉碎性骨折复位满意,固定牢固,肘关节功能恢复满意。

AIM： To observe the adverse effect and clinical efficiency of Y-shape plate internal fixation for treating comminuted distal humeral fracture. METHODS： A retrospective analysis was conducted in 18 patients with the comminuted distal humeral fracture, who were admitted in the First Affiliated Hospital of Nanyang Medical College from January 2003 to December 2006. All patients were treated with Y-shape stainless steel or Ti-alloy plate in 3-7 holes, then the response of materials and host was observed. The curative efficiency was assayed with Cassebaum score, and the healing of fractures was detected with X-ray film, During follow-ups, the pain and joint motion were observed. RESULTS： The mean operational time was 134 minutes, the mean value of intraoperative blood loss was 172 mL, and all the incisions were healed well. All the patients were followed up for 6 months, and the mean time for the fracture healing was 14 weeks. One case appeared delayed healing in the resection lesion, and Kirschner＇s wire was loosened in 2 cases. There was no infection, local inflammatory reaction or rejection reaction occurred. Among 18 patients, 11 got excellent results, 4 good, 2 fair, 1 poor, and the rate of excellent and good efficiency was 83.3%. CONCLUSION： Y-shape plate after implantation shows good biocompatibility with the human body, with the manifestations of good reduction of Comminuted distal humeral fracture, firm internal fixation, and satisfactory functional recovery of elbow joint.